Wikipedia talk:Identifying reliable sources (medicine)/Archive 2

Uptodate.com
There has been mention previously about the us of Uptodate.com as a secondary source. Wondering what people thought are about structuring references to this source? I have started siting both Uptodate and the primary research article so people without access can look at the primary source.

Doc James (talk) 15:31, 16 July 2008 (UTC)


 * UpToDate is a good source, but the best sections on UpToDate heavily reference the actual medical literature. As much as possible, we should use UpToDate as a guide to which literature is relevant and how to weight it,but citing UpToDate directly is a bit iffier since it's essentially one expert's opinion. That said, the site has an excellent reputation for accuracy and is a widely used professional resource, so it's not a matter of accuracy, more of how we approach things. MastCell Talk 15:55, 16 July 2008 (UTC)


 * I think UpToDate is a good resource, but heavily restricted even to many editors here, making it hard to access.
 * Jmh649 has started this discussion specifically because UpToDate is one of the secondary sources that cites . Now if we could find another secondary source that cites that paper, then I think this source would be preferable to UpToDate. JFW | T@lk  17:16, 16 July 2008 (UTC)


 * Or you could just use that primary source in good faith, and refer anyone who questions you to uptodate.
 * Should we set up a template, like for eMedicine ? --Steven Fruitsmaak (Reply) 17:25, 16 July 2008 (UTC)

Just one data point. I'd never looked into uptodate.com, so I thought I'd check it by looking at its coverage of the epidemiology of autism, an area I've worked on in Wikipedia. Uptodate.com's first sentence on the subject is "The prevalence of ASD in the United States and other countries has increased since the 1970s and particularly since the late 1990s". But this claim isn't true, and the source they cite (Williams et al. 2006, ) doesn't make the claim. What the source says is that the reported prevalence has increased, but it is not known whether the actual prevalence has increased; it could be that the changes are due to changes in diagnostic criteria or other factors. Admittedly this is just one data point, but still, wow, that's a pretty basic error. Accordingly: Eubulides (talk) 17:46, 16 July 2008 (UTC)
 * I'd like to second MastCell's suggestion to use uptodate.com as a source of plausible citations rather than to cite uptodate.com directly.
 * If there is some dispute about whether to cite (a 30-year-old letter to the editor?) I wouldn't rely on uptodate.com to resolve it.
 * Following up on my own comment: I see that later text in uptodate.com does make the point that autism's bureaucratic prevalence is not the same as its true prevalence, so I was too critical: it's more a major editorial error in uptodate.com than an actual content error. And it is just one data point. Still…. Eubulides (talk) 17:51, 16 July 2008 (UTC)

That actual reference from Uptodate JFW is referring to is: Doc James (talk) 20:31, 16 July 2008 (UTC)


 * Mea culpa, dropped a digit. I have refactored your comment to include the citation rather than the entire abstract. A primary research study in 197 subjects remains problematic. JFW | T@lk  21:12, 16 July 2008 (UTC)

In follow up I would like to mention that the article from Uptodate was used to emphasis a point made by the systematic review. That the amount of exercise has an effect on the degree of weight lose. It was not used to "debunk" the systematic review. See page on obesity.

Doc James (talk) 15:25, 17 July 2008 (UTC)

uptodate is peer reviewed - here is what they say about there process:


 * Editorial policy
 * Authors
 * All topics in UpToDate are written by the listed authors in 	conjunction with a deputy editor. Authors are identified as experts by the 	Editors-in-Chief, our editorial staff, and the participating societies. 	Exceptions are guidelines from major societies, which are added to UpToDate 	in their original form. All material is originally prepared by the contributing 	author(s) whose name(s) and affiliation(s) appear in the upper left corner of 	each topic. This material is reviewed extensively by our physician editors 	and peer reviewers for accuracy and completeness of the literature search, and 	for consistency with all aspects of the editorial policy.

Doc James (talk) 17:53, 20 July 2008 (UTC)


 * There is no doubt that UpToDate is peer-reviewed, but it remains expert opinion in review form with an uncertain selection process. The content is also not permanent and the same URL may lead to content that is liable to change. If there is a recent review available in a "real" journal this is vastly preferable over UpToDate.
 * What does the panel think about using UpToDate as a "hidden" supportive source. For instance, a primary research study is cited on UpToDate, thereby confirming its relevance, so the editor who includes that reference makes a comment in the reference code (not visible to the general reader) that the reference is cited by UpToDate? Thereby we satisfy the demands of this policy without overburdening the reader with a resource they are unlikely to be able to access even by interlibrary loan? JFW | T@lk  07:47, 21 July 2008 (UTC)


 * Hidden sources give me the willies. Wikipedia should be open about its sources, even if the sources themselves are closed. Eubulides (talk) 07:58, 21 July 2008 (UTC)


 * I don't understand how this is really "hidden". We are actually citing the primary source, and justify its importance under the "reviews preferred" aspect of WP:MEDRS by saying that it was cited by UpToDate.  So long as you then actually read the primary source, to meet WP:CITE, then I have no problem with this.  WhatamIdoing (talk) 20:48, 22 July 2008 (UTC)


 * Sources the ordinary reader can't see are hidden to the reader. If there's a reliable review, and the reason we're citing the primary source is that the reliable review cited it, then we typically should be citing the reliable review and not the primary source. This is true regardless of whether the review is published in uptodate.com or elsewhere. There are some exceptions to this (for example, notable primary sources worthy of discussion directly in the article text), but the exceptions shouldn't be common; and even then, it's better to cite recent reviews in addition to citing the primary source directly. Eubulides (talk) 23:03, 22 July 2008 (UTC)

RSN that may interest some editors here
I have revived a question at RSN on pseudonymous authors of "letters to the editor" in otherwise reliable sources. It may interest some editors here, and as the only editor who supports this source is demanding responses from additional editors to demonstrate "consensus", I am looking for editors who are willing to read it and respond.

Note that I don't have a vested interest in the outcome; I just want it very thoroughly settled one way or the other. WhatamIdoing (talk) 18:06, 4 August 2008 (UTC)

Process for guideline status?
Does anyone know what the proper procedure is to have this adopted as a guideline? WhatamIdoing (talk) 17:27, 5 August 2008 (UTC)
 * Huge can of worms and pet peeve extraordinaire alert. There isn't one, there should be, there is no coordination, but some editors are vehemently opposed to any efforts to centralize and coordinate MoS.  In terms of history, we (MEDMOS) were actually the only WikiProject to be subjected to a process.  In the olden days, Radiant! tagged our page (historical, I think), and we had to jump through hoops to get added to MoS.  We posted to several dozen other Projects, the Village Pump, etc. to garner widespread consensus for our guidelines.  To my knowledge, no other MoS page has ever had to do that.  When I proposed something similar at MoS, it was rejected.  Summary: we have a mess at MoS where a few editors can put together a page and call it a guideline with no mechanism for gathering broad consensus.  And I'm supposed to make sure FAs are MoS-compliant, per WP:WIAFA crit 2, even though guidelines often contradict each other.  Back when I proposed this, someone started a MoS WikiProject, which was promptly ignored.  I could find all of these links if I had to, but it would take me a very long time.  Ugh.  Sandy Georgia  (Talk) 17:32, 5 August 2008 (UTC)

By the way, the place to get our reliable sources text included would be at WP:RS, but it was already moved out of there, back during the old WP:ATT debacle, so that is yet another can of worms alert. Sandy Georgia (Talk) 17:34, 5 August 2008 (UTC)


 * I'm sorry things are such a mess. So, Sandy, what would make you (and therefore the FA process) happy?  Would you like me to declare this a guideline on the grounds that the editors of this page largely agree that other people ought to follow our excellent advice?  Would you like me to pretend that such a thought never crossed my mind?  Would you like me to invent an "RfG" process for you?  WhatamIdoing (talk) 17:51, 5 August 2008 (UTC)

Should we make this a guideline?

 * The following discussion is an archived record of a request for comment. Please do not modify it. No further edits should be made to this page.  

A summary of the debate may be found at the bottom of the page.

Should we make this a guideline? reason=The reliable sources page for medicine-related articles at WP:MEDRS is widely used and widely referenced on talk pages. WikiProject Medicine solicits comments on the page before assigning it guideline status. time= 22:03, 10 August 2008 (UTC)

It may not be perfect, but this page is in good shape and doesn't appear to conflict with any policies or other guidelines. Should this be an official guideline for Wikipedia? WhatamIdoing (talk) 22:03, 10 August 2008 (UTC)


 * Support guideline status. --Arcadian (talk) 18:15, 5 August 2008 (UTC)
 * Support guideline status, but awaiting Sandy's reply on consensus vs guidelines. JFW | T@lk  20:25, 5 August 2008 (UTC)
 * I don't know the answer to that; I wasn't one of the roadblocks in the past discussions, I'm not sure how you can overcome them, and if I had my druthers, our text here would still be part of the WP:RS page :-) One point, though, is that reliable sources are dealt with at WP:RS, while the template at WP:MOS is about style guidelines, so I'm not sure how we make a reliable source guideline part of manual of style guidelines, particularly considering certain parties fought to get reliable scientific sources removed from sourcing pages. Ummm ... and I've already been to ArbCom twice, so count me out when it comes to sorting out this little hot potato :-)) So far, it hasn't been a problem at FAC, but if it ever is, I may run screaming from the building. Sandy Georgia  (Talk) 22:07, 5 August 2008 (UTC)
 * New info. Considering that Scientific citation guidelines is part of the style guidelines, perhaps I'm wrong?  Who knows the history of that page, and what they had to do?  That would be a starting place. Sandy Georgia  (Talk) 22:26, 5 August 2008 (UTC)


 * Support: This should be a guideline simply because it encapsulates current best practices. There are still some tweaks that need to be made, but no deal-breakers. This should supplement (not replace) WP:V, WP:RS, WP:NOR, WP:MOS, etc, on medical articles, of course. Oh, as to process - just mark it a guideline. If someone strongly objects, we'll hear about it soon enough. MastCell Talk 22:15, 5 August 2008 (UTC)


 * Sandy, you're right: This is really a content guideline, not a style guideline.  (We should probably put a link to WP:SCG somewhere on the WPMED pages.)  Perhaps if there are no objections by tomorrow, then we'll make this change.  WhatamIdoing (talk) 17:09, 6 August 2008 (UTC)


 * Yes, it's troubling that content and sourcing guidelines are being added to style guidelines, but considering the chaos that is MoS and the lack of a method for sorting MoS issues, I don't know how to go about solving that. Someone really needs to take on WP:MOSCO and invigorate the entire process of fixing MoS, but I don't have time. Sandy Georgia  (Talk) 17:15, 6 August 2008 (UTC)


 * So with a bit of looking about, I've found that the closest thing we have to a proper process is proposed or an RfC. I've chosen the RfC, because it seems more appropriate for a page that is widely used and not really "under construction".  Mostly I don't want someone to be able to say later, "Well, it's only a guideline because you say it is, and I disagree, so therefore it's not a guideline."  WhatamIdoing (talk) 22:07, 10 August 2008 (UTC)


 * Support and should be linked to from WP:RS from a new sub-section in the "Reliability in specific contexts" section. I note that the Scientific citation guidelines is mostly style with a little bit of "when to cite" and doesn't venture into the source-selection business. We should keep content/sourcing guidelines separate from style guidelines. This doesn't belong in MoS. Colin°Talk 12:50, 10 August 2008 (UTC)


 * Against. The idea that reviews are somehow more reliable than original publications promoted in this paragraph: "In general, Wikipedia's medical articles should be based upon published, reliable secondary sources whenever possible. Reliable primary sources should be used with great care because of the potential for misuse. For that reason, edits that rely on primary sources should only make descriptive claims that can be checked by anyone without specialist knowledge. Where primary sources are cited, they should be presented in a manner which hews closely to the interpretation given by the authors or by published, reliable secondary sources. Primary sources should not be cited in support of a conclusion which is not clearly adduced by the authors or by reliable secondary sources, as defined above (see Wikipedia:No original research)." - is batty. The reviews are written by the same people who do the original research, and they are subjects of the same personal prejudices and biases. Every warning and rule applicable to the primary sources equally applies to the secondary sources: "Reliable secondary sources should be used with great care because of the potential for misuse. For that reason, edits that rely on secondary sources should only make descriptive claims that can be checked by anyone without specialist knowledge. Where secondary sources are cited, they should be presented in a manner which hews closely to the interpretation given by the authors. Secondary sources should not be cited in support of a conclusion which is not clearly adduced by the authors (see Wikipedia:No original research)." Paul Gene (talk) 20:42, 10 August 2008 (UTC)


 * Paul, the discussion about how to apply WP:PRIMARY to medicine-related articles is higher up on the page. WhatamIdoing (talk) 21:09, 10 August 2008 (UTC)


 * Review articles are much to be preferred because they provide the context often lacking in primary studies. They weed out primary studies that have not been replicated. And yes, in a small minority of cases they propagate bias. But the number of biased reviews pales in comparison to the number of primary studies that are poorly designed, do not prove or disprove the null hypothesis. have significant methodological problems etc. We have, above, arrived at a widely supported version by Eubulides that takes all these factors into account. It is still possible to cite primary studies, but preferably backed up by a secondary study that proves its relevance and acceptance as a representative piece of scientific enquiry.


 * For those who are surprised by Paul's vote, this thread on WT:MEDMOS started it all. JFW | T@lk  21:26, 10 August 2008 (UTC)


 * The argument that secondary sources are no better or less risky than primary sources, and so should not be preferred, goes against WP policy in WP:NOR. This guideline is unable to deviate from such policy. Colin°Talk 09:46, 21 August 2008 (UTC)


 * Your blind insistence that secondary sources are better goes against WP policy in WP:NOR, which states Deciding whether primary or secondary sources are more suitable on any given occasion is a matter of common sense and good editorial judgment, and should be discussed on article talk pages. Paul Gene (talk) 09:03, 24 August 2008 (UTC)
 * Selective quoting and exaggeration do your case no favours. You know fine well that WP:NOR prefers secondary sources and that WP:MEDRS is merely repeating the same guidance. Primary sources can be used "with care", which is exactly what "common sense and good editorial judgement" are for. Calling me blind is rude. I haven't said they "are better" in the sense you imply -- that they are always better in all circumstances. Please can you point out where this proposed guideline deviates from policy, or fails to accurately reflect that policy. One could add a "use common sense and good editorial judgement" caveat after every guideline in WP, but it is already enshrined in policy. Colin°Talk 10:00, 24 August 2008 (UTC)
 * I think that the primary/secondary source wording here is designed to address a problem: in some areas, editors selectively cite primary studies to undermine or "rebut" a consensus of expert bodies as expressed in reviews, position statements, etc. See abortion and mental health. See Duesberg hypothesis (the older versions). See passive smoking (older versions and talk page). See pretty much any article on vitamin supplementation. We're not going to suspend commonsense in dealing with grayer areas. I agree with some of Paul's concerns about reviews: it is (relatively) well-known that drug companies solicit authors and target review articles to specific journals in an effort to promote their products, a practice particularly documented in the psychopharmacologic literature. We need to exercise caution and commonsense regardless of whether we're talking about a primary or secondary source, but I think this guideline is useful clarification of WP:RS and WP:NOR. MastCell Talk 18:39, 25 August 2008 (UTC)
 * I agree with MastCell's statement. &mdash; Mattisse  (Talk) 19:01, 25 August 2008 (UTC)


 * Support Great article that deserves wider use. --Ronz (talk) 18:58, 20 August 2008 (UTC)


 * Support. Would make a great addition to RS. -- Fyslee / talk 19:34, 20 August 2008 (UTC)


 * Oppose. It is unclear what are independent, or third party, sources for the purposes of Wikipedia. --Mihai cartoaje (talk) 07:17, 21 August 2008 (UTC)
 * It is unclear whether this is a criticism of a supposed requirement in MEDRS for "independent, or third party, sources" (and such a requirement doesn't exist since those words don't appear in the guideline) or of the lack of such a requirement in MEDRS. Can you make your opposition clearer, so that any issues can be resolved. Thanks. Colin°Talk 09:46, 21 August 2008 (UTC)
 * The second. WP:RS requires third-party sources. I don't think Project Medicine editors can overrule Wikipedia policies. Anyone can start a wikiproject. --Mihai cartoaje (talk) 06:55, 25 August 2008 (UTC)
 * Unclear? WP:PSTS doesn't cover it in enough detail? --Ronz (talk) 21:43, 21 August 2008 (UTC)
 * A look at the comments on this user's talk page suggests that Wikipedia content policies in general are unclear to this user. WhatamIdoing (talk) 00:48, 22 August 2008 (UTC)
 * Strongly suggest that this users vote is pretty much ignored, almost certain a vandal who has already tried to get Jfdwolff desysoped. —Cyclonenim (talk · contribs) 22:09, 22 August 2008 (UTC)
 * Third-party, not tertiary. It means non-partisan. --Mihai cartoaje (talk) 06:55, 25 August 2008 (UTC)
 * WP:OR already prefers the use of secondary sources. We merely repeat that mandatory policy here, with an explanation of how an editor might be able to comply with that policy.
 * WP:RS already prefers the use of independent, third-party sources. Would you be happier if we redundantly repeated that preference here?  Note that it's not necessary in practice, because this adds to the normal RS rules instead of replacing them; writers of medical articles would be bound by all of the above, not just this one.  WhatamIdoing (talk) 20:59, 25 August 2008 (UTC)
 * It would be an improvement. But I would still oppose it because if we disregard everything that is an attempt to overrule WP:RS, there is almost nothing left. --Mihai cartoaje (talk) 12:27, 20 September 2008 (UTC)
 * Well, I didn't get desysoped. Mihai, the selection of "third party sources" is foremost an editorial decision guided by the principles set out in this guideline. As you will find, it is very hard to identify a completely impartial perspective in medicine because the secondary sources are written by those with a research interest into the topic being reviewed. But these sources tend to be vastly better than any third party reviews by uninformed observers. JFW | T@lk  23:47, 25 August 2008 (UTC)
 * Most of the supporters are the same group that recently tried to remove all information about malpractice from the Medecine article. --Mihai cartoaje (talk) 13:15, 23 September 2008 (UTC)


 * Support as per MastCell and Colin. Eubulides (talk) 09:10, 21 August 2008 (UTC)


 * Strong support, I've already been using this as a guideline, anyway. —Cyclonenim (talk · contribs) 22:03, 22 August 2008 (UTC)


 * cautious/weak Support-ish - I know where Paul Gene is comng from, and (especially in psychiatry) seen quite a bit of schism in views depending on which secondary source one looks at. I do like the idea of acknowledging that the same is possible for secondary sources, though generally less likely. And that if possible, try and get an expert in the area. Cheers, Casliber (talk · contribs) 22:13, 22 August 2008 (UTC)
 * Support. Any real issues can easily be addressed on a case-by-case basis and the scholarly consensus is usually well-represented in any well-reviewed reliable source, including lit reviews and whatnot.  WLU (talk) 22:37, 22 August 2008 (UTC)


 * Oppose. I understand and share the desire to have a guideline such as this, but I cannot support it.  I have read far too many mediocre review articles that are a giant step backward from the primary sources they cite.  (Also, I take issue with the Wikipedia idea that synthesis is a form of original research.  Both synthesis and original research are original work, and therein lies the confusion.) --Una Smith (talk) 05:01, 23 August 2008 (UTC)
 * You're opposing a guideline because it reflects Wikipedia policies, which you state you disagree with ? There is mediocrity in every area of publication; that doesn't mean we engage in synthesis and original research on Wiki. Sandy Georgia  (Talk) 05:12, 23 August 2008 (UTC)
 * Certainly not. I oppose this guideline because in my opinion it is not an improvement on Reliable sources. --Una Smith (talk) 18:45, 24 August 2008 (UTC)
 * It would be most helpful then, if you could indicate which areas it is deficient in being more help to writers of medical articles. Or do you feel that nothing needs to be said that isn't already said in WP:RS? Colin°Talk 19:15, 24 August 2008 (UTC)
 * Una, do you then disagree with the premises of this policy? Rubbish reviews exist. In most cases, there are higher quality reviews that could be selected on the basis of editorial judgement. If worst comes to the worst (as I found on central core disease, for instance), a primary study may be acceptable. The policy has inbuilt levers for this kind of situation. JFW | T@lk  23:47, 25 August 2008 (UTC)
 * Answering both Colin and JFW... The intent is to offer brief, simple descriptions of how to evaluate the quality of sources, but as we all know the usual effect is to create prescriptions:  literal thou shalts and shalt nots.  If I were to write a prescription for Wikipedia re the use of editorial judgment it would be "write no prescriptions".  Editorial judgment of this kind is not easy to learn, and it usually is taught rather intuitively via the process of learning to write research proposals.  For a synopsis of how to develop editorial judgment, I like Jan A. Pechenik's (1987) A short guide to writing about biology, chapters 4 (writing research proposals) and 5 (writing summaries and critiques).  The proposed guideline is far too prescriptive, and it also invokes stereotypes (eg, this kind of review better than that kind, this journal has higher impact factor, etc.) rather than dealing directly with the real problem.  The real problem is simply how to decide if one source is better than another, in the context of a given article.  I think the merits of specific sources, relevant to a given article, should be discussed on that article's talk page.  That is where I see the best demonstrations of editorial judgment in use.  --Una Smith (talk) 05:10, 28 August 2008 (UTC)
 * I would counter that this is only going to be a guideline that can be deviated from with good rationale. However, in my experience (and clearly that of many other support voters), the kind of prescriptive guidance is exactly what we need to improve the quality of medical articles. My most effective editing still comes about with the help of well-authored secondary sources from high impact journals. JFW | T@lk  06:37, 28 August 2008 (UTC)


 * Support. We've worked on this for years; it's ready.  Sandy Georgia  (Talk) 05:12, 23 August 2008 (UTC)
 * You barely worked on it for a month. It is not ready. There is still an active discussion going on. Paul Gene (talk) 09:03, 24 August 2008 (UTC)
 * SandyGeorge first edited this article with series of edits on 12 April 2007 and 13 April 2007. That's more than one year, and certainly more than a belittling "a month" :-) David Ruben Talk 23:20, 24 August 2008 (UTC)
 * Apologies, I was wrong. But then Sandy's edits are mostly formatting and reverting other editors. A great number of edits adding very little content. Paul Gene (talk) 07:05, 25 August 2008 (UTC)
 * Having a bad day, Paul Gene? I seem to remember working on these pages for months on talk; sorry you weren't around when some of us were in the trenches.  Sandy Georgia  (Talk) 07:28, 25 August 2008 (UTC)


 * Support. The document has been discussed at depth and at times, er, robustly. I don't see any active discussions going on, and am confident that we can handle them as and when they arise. Nmg20 (talk) 17:35, 24 August 2008 (UTC)
 * Support - for reasons given by Mastcell above. &mdash; Mattisse  (Talk) 19:04, 25 August 2008 (UTC)
 * Strongest possible support Somehow, I'm find myself late to this party. I blame MastCell for not informing me.  If this were a guideline, it could be used to finally remove cruft from medical articles.  I cannot wait for this to be policy around here.   Orange Marlin  Talk• Contributions 17:36, 27 August 2008 (UTC)
 * Support. I'm not a member of the project, but I'd like to voice my support anyway. One potential issue that I don't see addressed though: How to do you deal with primary research articles that have been published after the latest reviews? I think if someone really wanted to, s/he could twist the policy to mean that such papers should be excluded, and I don't think that's good idea. (Certainly caution is warranted in dealing with primary sources that haven't yet been reviewed, but I don't think they should be excluded outright.) Anyways, this not a deal breaker, and as a whole, I think this guideline is a great idea. Yilloslime (t) 20:34, 27 August 2008 (UTC)
 * Currently it says "Prefer recent reviews to older primary sources on the same topic." That seems clear to me, but if you see confusion perhaps you could propose better wording? Eubulides (talk) 20:53, 27 August 2008 (UTC)


 * The above discussion is preserved as an archive of the debate. Please do not modify it. No further edits should be made to this page.

I find the arguements for making this a guideline compelling. Whilst some sensible concerns raised, overall the WP:MEDRS acts as a additional help to the main WP:RS, giving pointers & issues that may apply in biomedical topics. Of course any specific review article might be found wanting, this can also occassionally apply to primary source research papers which may be questioned with authors & journals later ammending or even rarely retracting. Clearly therefore one can not be absolutist, and so this is a guideline and not a policy with header instruction that it be "treated with common sense and the occasional exception". In general therefore RS prefers secondary sources to primary in outlining a topic, but MEDRS seeks to give a little greater creadance and advice on citing the primary sources for the origin of items of knowledge.

As RS states "In science, single studies usually are considered tentative evidence that can change in the light of further scientific research. How reliable a single study is considered depends on the field, with studies relating to very complex and not entirely-understood fields, such as medicine, being less definitive. If single studies in such fields are used, care should be taken to respect their limits, and not to give undue weight to their results. Meta-analysis and systematic reviews, which combine the results of multiple studies, are preferred (where they exist)."

I see no direct objection above that common sense is required in looking at how any one source (review article, primary research or indeed a "standard" textbook) compares to the bulk of other sources - for WP:UNDUE weight needs to be considered for views that do not follow the majority viewpoint if we are to maintain WP:NPOV (in essence a review article or text book that presents a view not held by the majority is in a minority whatever type of source it is). That said, a citable-reference in a reliable-publication-source that tries to summarise an overall topic and its current research-base, is likely to assesss the importance or otherwise of individual primary sources better than any editor (who so summarising themselves would be at risk of WP:Synthesis which is original research).

Therefore I promote this MEDRS from proposal to an accepted guideline in light of satisfactory consensus above. This does not of course preclude the guidence to be discussed below and, hopefully, improved further :-) David Ruben Talk 00:53, 1 September 2008 (UTC)


 * As an editor, I have had a 1st go at adding a nutshell header - feel free to discuss and tweak that David Ruben Talk 00:53, 1 September 2008 (UTC)


 * Thanks David. I think this is a major step forward. I hope we can settle some final disagreements (below) pretty soon now. JFW | T@lk  05:26, 1 September 2008 (UTC)

Systematic reviews and primary sources
This edit removed the following sentence from WikiProject Medicine/Reliable sources without discussion:
 * A systematic review is both a primary and secondary source—it summarizes other papers but it does so in order to research the field and possibly come to a novel conclusion.

with the comment "this is really not true -- a good systematic review basically summarizes previous findings only. Looser reviews do the more primary work." Possibly-controversial edits like this should be discussed on the talk page first, so I took the liberty of reverting the change and moving the text here, for discussion. Eubulides (talk) 02:20, 15 August 2008 (UTC)


 * I actually support removal of this sentence. In the vast majority of cases, systematic reviews make no new observations at all. Non-systematic (or "narrative") reviews occasionally reflect expert experience without an evidence base, but they remain reviews in their editorial sense. JFW | T@lk  02:22, 15 August 2008 (UTC)


 * I honestly didn't think that removing this sentence could possibly be controversial, as it seemed to be superflous in addition to being false. I thought about simply cutting the word systematic from the sentence, but I figured that might be controversial! II  | (t - c) 02:42, 15 August 2008 (UTC)


 * I also support the removal of that sentence since it differs from the definition of the term in the article at systematic review and from the use of the term in the lead paragraph of this page. --Jack-A-Roe (talk) 02:57, 15 August 2008 (UTC)

The sentence in question has been present in nearly its current form since the talk page was created in 2006. It was added in the very first change to the article, by Colin, the original author of the page, here. I'll leave a note on Colin's talk page to ask him to weigh in on this issue. Eubulides (talk) 05:31, 15 August 2008 (UTC)


 * Feel free to correct my mistakes -- I'm just an amateur. I bow to the folk with training in this subject! I wrote that a while ago and might have worded it differently now. I've always hoped, in fact, that someone with training/qualifications in this area would rewrite much of MEDRS, while keeping those aspects that are unique to WP. Re-reading Greenhalgh's How to read a paper: Papers that summarise other papers (systematic reviews and meta-analyses), I can see how I thought the "novel conclusion = primary" might occur with such papers. If you guys think that is rare then clearly the sentence isn't useful. Here's my impression: A narrative review by an expert might be likely to have a conclusion that the expert already "knew" before he even started working on the paper. He's set out to describe rather than systematically discover the current situation. A systematic review is an objective exercise in examining the published research and the results might surprise the author(s). Such a review might gain access to the raw data from published trials, and other less accessible input (see the "Checklist of data sources for a systematic review" in Greenhalgh's paper). If the review contains a meta-analysis or other synthesis of results, then arguably it produces its own conclusion (even if this is similar to and adds weight to what was "known" already). The publication of a Cochrane review can make the newspapers, so it must be saying something we haven't heard before or with as much conviction.   Still, I agree that it may be simpler to just consider such reviews to be excellent secondary sources. Colin°Talk 18:33, 15 August 2008 (UTC)


 * Thanks for following up. In rereading the article it seems clear to me that something needs to be said here about systematic reviews, as systematic reviews are mentioned in the lead and therefore need to be in the body as well. How about if we remove the phrase about primary and secondary source, along with a newly-redundant phrase, as follows:
 * A systematic review is both a primary and secondary source—it summarizes other papers but it does so in order to research the field and possibly come to a novel conclusion.
 * Eubulides (talk) 20:09, 15 August 2008 (UTC)
 * Eubulides, edit away and expand if you can. Please, the more you can add to this proto-guideline the better IMO. Colin°Talk 20:21, 15 August 2008 (UTC)
 * OK, thanks. For now the consensus seems to be that this change is OK, so I put it in. Expanding will take more work.... Eubulides (talk) 18:57, 22 August 2008 (UTC)


 * I support the direction you seem to be taking with your edits above. In my mind systematic reviews are not given their due. They should not be lumped in with primary sources, or with summary reviews of the literature that frequently precede the presenting of original research in a journal article. The latter is often self-selected to support the hypothesis the researcher is evaluating, but I frequently see these reviews (often in abstract form) used as a secondary source. &mdash; Mattisse (Talk) 20:32, 15 August 2008 (UTC)


 * Hmm. I don't oppose the addition of that sentence, but I think it is bit superflous. Systematic review is wikilinked in the lead. We don't really need define it in MEDRS. Incidentally, Mattisse, I actually previously supported emphasizing systematic reviews, but if I recall correctly JFW wasn't really happy about that(not sure what Eubulides thoughts on the matter were). Then again, the page on systematic review already states that these are the standard in evidence-based medicine, which works just as well. Actual medicine guidelines > MEDRS in my mind. I actually think modularity in these articles is best -- keep the things which are strictly MEDRS here, and fork off tangents and definitions elsewhere. And, no offense, but that sentence is a "duh" sentence. It's a "duh" statement that in most cases, reviews will synthesize the literature and come to their own, possibly novel, probably not novel, conclusion. If you want to add that sentence, you're going to have to at least strike the word systematic from it, Eubulides. II  | (t - c) 19:07, 16 August 2008 (UTC)


 * I have never opposed the use of systematic reviews, and indeed I feel that we should place much emphasis on them. But they tend to be relatively narrow in scope and broad in methodological thoroughness. Hence, "narrative reviews" are great for broad sketches, while systematic reviews are better at answering specific questions. JFW | T@lk  21:56, 17 August 2008 (UTC)


 * There seems to be some confusion here, as the proposal is to remove some text, not to add it.
 * Removing the entire systematic-review sentence would be unwise, as the containing paragraph discusses all sorts of article types, and discussing other article types while omitting mention of systematic reviews (a preferred source) would be very odd.
 * It's not a "duh" statement to define a systematic review; we can't expect all Wikipedia editors to know what it is. The paragraph already defines general reviews, and it's useful for it to make a point about systematic reviews and what makes them different. If you prefer a different definition for "systematic review", please propose something.
 * Eubulides (talk) 23:12, 16 August 2008 (UTC)


 * I don't think it needs to be defined, and I don't think they come to novel conclusions. Generally a systematic review will have one of two conclusions: 1) Not enough evidence, 2) Enough evidence, some consistent result. The paper pointed by Colin has good summary of them, and I think it would be nice to actually reference that paper in this article. A good definition would note that a systematic review uses a predefined, replicable methodology to select all articles from a certain time period, with predefined inclusion criteria. II  | (t - c) 01:15, 18 August 2008 (UTC)


 * WP:MEDRS defines/discusses general reviews (which are mentioned in the lead); for consistency shouldn't it also define/discuss systematic reviews (also mentioned in the lead)? It would be odd for the lead to mention a topic not discussed in the body. The current (and proposed) wording doesn't say that systematic reviews always come to novel conclusions, only that they "possibly" come to novel conclusions. Again, if you could propose specific wording to replace the proposal above, that would help drive the discussion forward more quickly. Eubulides (talk) 19:42, 18 August 2008 (UTC)

II | (t - c) 20:06, 18 August 2008 (UTC)


 * I assume this is intended to replace the last 3 sentences of WP:MEDRS ? If so, the proposed replacement has two major problems. First, it disses general reviews far too much. General reviews, when done well, are better sources for Wikipedia than systematic reviews are, since they match Wikipedia's encyclopedic aims better. Second, WP:MEDRS is descriptive: it does not (and is not intended to) give advice. Advice is in WP:MEDRS  and proposed changes to advice should be made there. Eubulides (talk) 20:13, 18 August 2008 (UTC)


 * Sorry, it is intended to replace the last sentence only. I tweaked it slightly. General reviews are only as good as the sources (or perhaps the credentials) of the author. If the review cites only one primary study for a claim, its reliability is not much better than that primary study. I don't understand how general reviews are more encyclopedic. They are certainly not more reliable than systematic reviews. As far as "advice", I think that's your opinion. This page is a guide, and I think it should read as such. But if you prefer, the second sentence can be changed to "" Any other advice? II  | (t - c) 20:28, 18 August 2008 (UTC)

(Undent.) As discussed previously, editorial judgement is advised when selecting sources and citing their contents. But secondary sources will generally trump primary sources for most citations, and I don't think we should try to codify for exceptions. I dispute the claim that systematic reviews can answer complex medical questions; in the vast majority of cases, the data is so insufficient or contradictory as to allow for the drawing of definite conclusions about complex medical questions. Back to you, ImperfectlyInformed. JFW | T@lk  20:50, 18 August 2008 (UTC)


 * Yes, and here we go again. I'm not codifying for exceptions. I'm just pointing out that some attention should be paid to the sources cited by a review. That's probably the most important part of editorially analyzing reviews. As far as systematic reviews actually answering the questions, perhaps you're right. But they are considered to have the best chance at answering these types of contentious questions, and they are the best at putting the question into proper context, since they attempt to include all context. II  | (t - c) 21:17, 18 August 2008 (UTC)

I think we're actually much in agreement regarding the place of various types of publications. In a world full of evidence, systematic reviews (especially of the Cochrane flavour) would answer any question. JFW | T@lk  21:31, 18 August 2008 (UTC)
 * agreed. Systematic reviews of this sort are in fact the goldstandard and the very model of an authoritative secondary/tertiary source. ; the Cochrane series are not the only ones--there are also other formal consensus statements issued by appropriate groups. When they don'ta gree, which is not unheard of, w need only present the different ones equally. I wish other fields were as well organized for such things. DGG (talk) 04:14, 19 August 2008 (UTC)

I agree with Eubulides and JFW that the proposed text disses general reviews too much. I don't really know what the "should be used with a consideration of the sources cited by the author" is supposed to add. Many editors won't have the ability/experience/training to judge whether the review's sources are balanced/good (and so just have to trust that a review published in a good journal is probably good). Those that are capable of judging the quality of a review probably don't need to take advice on this matter from Wikipedia! I wonder if II you are thinking too much about arguing about the efficacy of therapies rather than trying to write a rounded encyclopaedic article on a subject. A good general review provides far more than just an "introduction to a topic". In the ketogenic diet, I was able to source whole paragraphs to narrative review sources such as Clinical Aspects of the Ketogenic Diet. I used two systematic reviews: Ketogenic Diet for the Treatment of Refractory Epilepsy in Children: A Systematic Review of Efficacy and Ketogenic diet for epilepsy (the former funded by US insurance companies in 2000 and the latter from the Cochrane Database of Systematic Reviews 2003). Both answered only one question, "does it work", and both said "weakly yes, but there are no randomised controlled trials" and are dated since such a high quality trial was finally published in 2008. Both those systematic reviews read much like a primary research paper (background, methods, results, discussion, conclusion) and are so focussed that they aren't any use for the rest of the WP article.

Guidelines
I agree with DGG about the "other formal consensus statements issued by appropriate groups". Currently, MEDRS doesn't mention clinical guidelines. Two excellent sources I have used are the guidelines for Scotland and England and Wales. I know less about the US but I have seen consensus statements begin published (self or in journals) by various medical professional bodies and by some of the more respectable charities. Could we add some mention of this to MEDRS? Colin°Talk 08:28, 19 August 2008 (UTC)


 * Guidelines tend to be limited in geographical scope. NICE does not pretend that its guidelines are valid outside England and Wales, and therefore not everything recommended by that body is therefore necessarily representative of practice in the rest of the world. An example would be the risk stratification algorithm for warfarin in people with atrial fibrillation; this is a novel system not used elsewhere. Similarly, its guidelines on computed tomography of the brain after head injury may differ substantially from similar guidelines elsewhere. As a result, I prefer to use reviews in preference over guidelines; that said, they can be excellent sources of information (e.g. the British Society of Gastroenterology guideline at coeliac disease). JFW | T@lk  18:49, 19 August 2008 (UTC)


 * I like the idea of mentioning guidelines, but agree with JFW that the area's a bit tricky. In Chiropractic I've had to deal with the problem that there are three competing groups of guidelines for treatments used by chiropractors: one by the majority "mixer" chiropractors, another by the minority "straight" chiropractors, and another being the mainstream medical guidelines. The three groups differ markedly in their results. Even if we restrict ourself to mainstream medical guidelines developed by national governmental organizations, guidelines in different countries disagree markedly; see Murphy et al. 2006.
 * My experience is that guidelines tend to be less useful than reviews as sources to Wikipedia articles than reviews are, not necessarily because they are lower quality, but because their goal (advice about treatment) is more distant from Wikipedia's goal (encyclopedic coverage) than the goal of reviews (broad and balanced coverage of a topic). Though of course guidelines often have good reviews within them.
 * Eubulides (talk) 19:19, 19 August 2008 (UTC)


 * Guidelines must be carefully evaluated. An institution like the Mayo Clinic may offer "guidelines" meant for the general public without any attempt to source or valid the claims. &mdash; Mattisse (Talk) 20:03, 19 August 2008 (UTC)


 * Again, editorial judgement is advised. The NICE guidelines, too, are sometimes expert/experience based rather than supported by evidence because such evidence is often lacking. Also, Matisse, we are talking about professional guidelines here, adherence to which is often mandatory and a yardstick by which professional performance is meausured, as opposed to resources for the general public that cannot legitimately be called "guidelines" but rather "advice" or "tips". JFW | T@lk  20:19, 19 August 2008 (UTC)
 * Well, psychology articles are notoriously awful, but these sorts of references are often used in articles on topics in psychology. I would like to see a firm way of discouraging it. &mdash; Mattisse  (Talk) 20:23, 19 August 2008 (UTC)


 * Sounds reasonable. JFW | T@lk  20:35, 19 August 2008 (UTC)


 * I have to agree with matisse, some of the guidelines I have seen put out by otherwise reputable bodies (stocked with professionals) have been pretty poor at times. Maybe a good caveat WRT secondary sources is ''be especially careful if one finds two or more sec. sources putting forth substantially variant positions/findings/information etc. Cheers, Casliber (talk · contribs) 22:29, 22 August 2008 (UTC)

Funny one I found - in australia (and apparently America), screening tools are fait accompli these days and promoted as such, yet the data seems to tell a different story..actually there was another BMJ paper which was even more cautious. Cheers, Casliber (talk · contribs) 22:34, 22 August 2008 (UTC)

Conflicting advice?
Hi - I apologize for making a few late edits to this proposed guideline, but I trust I'll be reverted if they're out of line. In any case, I wanted to raise what looks like conflicting advice. We emphasize the importance of secondary sources as the basis for medical articles - great. But in the section headed "In science, avoid citing the popular press", we tell people to cite specific researchers' papers rather than newspaper coverage of them. I understand where this is coming from, but we seem to be telling people to go to primary sources in preference to a good popular-press account, which seems a bit iffy. I'd prefer to re-title the section to "Use the popular press with caution" rather than "Avoid the popular press", and perhaps to indicate that popular press can be useful to adduce the sociological and cultural aspects of a disease, drug, etc. For instance, (quality) popular-press accounts are pretty much essential to a full understanding of the context around Lyme disease or Vioxx. "Avoid" just seems to strong. Thoughts? MastCell Talk 20:28, 27 August 2008 (UTC)


 * I'd agree with that. There are sometimes relevant stories covered in the op. press...I just need to think of an example now....maybe a medication taken in a notable court case, or erson diagnosed with a particular condition. etc. Cheers, Casliber (talk · contribs) 20:37, 27 August 2008 (UTC)


 * I agree also. The indiscriminate use of primary sources (small n, a few case histories, etc.) even from PMID to "prove" a general point is more of a problem, in my opinion, then using reputable popular press references which can be presented for what they are, a popular press review.  &mdash; Mattisse  (Talk) 21:09, 27 August 2008 (UTC)


 * Press reports are usually unsuitable as secondary sources. Here in the UK every rat study on beta amyloid is reported in the Daily Wail with huge headlines: "Dementia cure round the corner". JFW | T@lk  22:56, 27 August 2008 (UTC)
 * Well, the Daily Mail is certainly not a great source. Who was it that said they classify every substance known to man as either causing or curing cancer? :) I do think there's a role for high-quality popular press, like Scientific American or New Scientist (though I still haven't forgiven the latter for their inexcusable DCA hype, it's out of character). The New York Times also tends to have decent to excellent science and health coverage. MastCell Talk 23:05, 27 August 2008 (UTC)


 * Agree that whoever was behind the DCA garbage was hopefully and unceremoniously sacked. In other words, it does again boil down to editorial judgement on which popular press source is to be regarded as reliable. JFW | T@lk  23:18, 27 August 2008 (UTC)


 * It might be useful to list a few examples of legitimate uses for a popular media, such as reports on court cases, as Casliber mentions. Business/marketing issues, information about drug approvals, all sorts of scandals -- there's a lot of not-directly-scientific stuff that goes into some medicine-related articles.  WhatamIdoing (talk) 00:14, 29 August 2008 (UTC)

Like MastCell, I'd like to re-title this section. I think the main point to make here is that it's better to cite a study directly (and correctly) than to cite a mass media summary of a study. More links in the chain = more opportunities for errors. Also, quite a lot of what we need in basic medical articles isn't going to be available in a good newspaper. (When was the last time you saw a good anatomy article in The London Times?)

Perhaps more importantly, I think it should be expanded to add one sentence about things that mainstream media does better than scientific journals, such as the non-scientific end of things. It's not really "don't cite the popular press" -- it's really "don't cite the popular press for medical/scientific details. WhatamIdoing (talk) 00:51, 31 August 2008 (UTC)

Popular press and primary sources
This edit altered WP:MEDRS to say that most articles and press releases are primary sources in medicine. My experience is just the opposite: in medicine the primary sources are the research articles, and the popular press and press releases comment on the research articles. I reverted the change, and perhaps we can discuss the situation further here. Eubulides (talk) 01:40, 29 August 2008 (UTC)


 * Press releases are usually issued by companies or organizations soon after the publication of a scholarly article or even before such an article. They are usually a shortened or popularized version of the scholarly article without analysis, deeper interpretation or review of other relevant sources, which is a necessary pre-requisite for it being a secondary source. For example, these press-releases (like most press releases) are clearly primary sources:,  ,  ,  Please provide more evidence of your belief that press-releases are secondary sources. Paul Gene (talk) 02:11, 29 August 2008 (UTC)

A press release is a press release: it is what it is. We don't need to say anything specific about them on this page; that is for WP:V and WP:RS. Sandy Georgia (Talk) 02:13, 29 August 2008 (UTC)

Sandy, do you suggest deleting the mention of press releases from the definition of secondary sources? I would support that. Paul Gene (talk) 02:42, 29 August 2008 (UTC)
 * No, I think we've got it just right as is. We're in line with WP:PSTS and anything beyond that should be dealt with on main policy pages.  Sandy Georgia  (Talk) 02:51, 29 August 2008 (UTC)
 * Sandy, press releases are not mentioned in WP:PSTS. Insofar as the definition of secondary sources on WP:PSTS goes: "Secondary sources are accounts at least one step removed from an event.[3] Secondary sources may draw on primary sources and other secondary sources to create a general overview; or to make analytic or synthetic claims.[4][5]", most press releases do not fit it. Please see the examples of typical press-releases I gave above. Please provide more evidence of your belief that press-releases are secondary sources. Paul Gene (talk) 11:00, 29 August 2008 (UTC)


 * Eubulides, your opinion that news articles constitute secondary sources goes against the prevailing expert consensus. According to this definition, "In science, secondary sources are those which simplify the process of finding and evaluating the primary literature. They tend to be works, which repackage, reorganise, reinterpret, summarise, index or otherwise “add value” to the new information reported in the primary literature." Most of the articles in the popular press tend to simply report the news, with the information usually taken directly from a press release or an abstract. In addition, they are contemporaneous with the object/phenomenon, which is one of the distinctive characteristics of a primary source.("A secondary source is a work that interprets or analyzes an event or phenomenon well after the fact. It is generally at least one step removed from the event." )  This source  directly lists mass media as a primary source: Examples of primary sources: ... Mass media ... The products of the mass media can be primary source documents if they were produced at the time of the events or phenomena in question. Examples are: newspaper and magazine articles". Another source  also states Some examples of primary sources include:...Contemporary magazine and newspaper articles." I was not able to find any support for your argument that, unlike in historical sciences, in medicine the news articles are secondary and not primary sources. Paul Gene (talk) 02:45, 29 August 2008 (UTC)
 * Wiki's definitions are at WP:PSTS; we are in line with them, which is where we should be. Sandy Georgia  (Talk) 02:51, 29 August 2008 (UTC)
 * In other fields, e.g., political reporting, newspapers are indeed primary sources. For example, to report Barack Obama's position on the educational vouchers, Political positions of Barack Obama cites a Chicago Tribune article about a 2004 debate; this was a primary source on that debate. In contrast, in medicine, typically refereed journal articles are the primary sources, and press releases and/or newspapers report about the journal articles, adding commentary about their significance; these are secondary sources. For example, Morrow et al. 2008 published in Science a study about homozygosity mapping to identify shared genes in autism, and that same day a story about the study appeared in The Times. The Times story was a secondary source: it commented about the study, with quotes like "This publication a big event in the world of autism research", without directly accessing the original data that the study reported. There may be occasions where a newspaper would be a primary source on a medical topic, but these would be rare, I'd think; not worth mentioning or emphasizing here. Eubulides (talk) 03:27, 29 August 2008 (UTC)


 * Sandy and Eubilides, you are not in line with the definition of secondary sources at WP:PSTS: "Secondary sources are accounts at least one step removed from an event.[3] Secondary sources may draw on primary sources and other secondary sources to create a general overview; or to make analytic or synthetic claims.[4][5]" As I already mentioned, most of the stories in pop press are news articles, they are contemporary and thus are not sufficiently removed from the event to count as secondary sources. They generally do not provide analysis based on several other primary sources or create an overview of the topic. Many news articles in the political area often make comments similar to the ones made in the science Times story you are referring to. For example, in another news story http://www.timesonline.co.uk/tol/news/politics/article4615384.ece] Times comments: " The commission’s push for a national register, however, could be more controversial.", without directly accessing the original commission's report. Political reporting in the pop press in that respect is not any different from scientific reporting. Nevertheless, as the thrust of the press reports is on the news they are firmly considered to be primary sources. In order to re-define the pop-press reports of scientific news as secondary sources you have to provide the evidence that they are sufficiently different from other reporting. You have to back that up with  the quotations showing that scientific  reports in pop-press are considered by experts to be secondary sources, otherwise you are engaging into original research. In what I was able to find so far on the expert definitions of secondary sources as applied to  science, the pop-press reports appear to be firmly ruled out (see the definitions in my previous post).  Paul Gene (talk) 11:00, 29 August 2008 (UTC)

Whether we regard press releases as primary or secondary isn't the most important thing we can say about them. The vital point is that they are a biased source of information written at lay level which may not contain enough contextual information or balance of viewpoints in order to write a good encyclopaedic article. If the press office for hospitals/research labs are writing about newly published work, they are often effectively writing the journalist's article for them, so would be considered secondary sources. If they are reporting on unpublished data, then they are more like primary sources. If they contain quotations from the researchers, as though they had been interviewed about it, then the are also more like primary sources for that detail. Rather than trying to divide all published material cleanly into primary and secondary, it may be better to avoid the issue with certain sources, and concentrate on their strengths and weaknesses without classification. Colin°Talk 14:04, 29 August 2008 (UTC)
 * I agree with Colin's points. I looked at WP:MEDRS and its text currently does what it says: it does not say that the popular press or press releases are primary sources, or secondary sources. Perhaps some minor change to WP:MEDRS would help clarify this issue (to avoid further questions along these lines), but offhand I don't see what change that would be. Eubulides (talk) 18:26, 29 August 2008 (UTC)


 * I agree with Sandy: WP:MEDRS's version of PRIMARY just needs to line up with the normal WP:PRIMARY, while providing some useful information about how it might apply to a medicine-related article.
 * Press releases are difficult to assess in the PSTS model. A press release from the FDA about fining the American Red Cross Blood Services for long-standing cGMP problems is probably a primary source.  If the American Red Cross Blood Services issues a press release whining about it, then their press release is a primary source for their response, but probably a secondary source for the fact of the fine.  If a third organization issues a press release to chide the FDA for dragging their feet, then the third press release is a primary source for their opinions, but definitely a secondary source for the fact of the fine.
 * None of that changes the fact that none of these are issued by independent third-party sources with reputations for fact-checking (something that is mentioned in WP:V because it's a relevant legal standard). WhatamIdoing (talk) 19:46, 29 August 2008 (UTC)


 * Sandy, what is your problem with deleting the questionable paragraph and just leaving it up to WP:PRIMARY to deal with? I thought that was essentially what you suggested. WhatamIdoing also agrees that press-releases are difficult to assess in the PSTS model. Colin also says that "Whether we regard press releases as primary or secondary isn't the most important thing we can say about them.". Eubulides says "I looked at WP:MEDRS and its text currently does what it says: it does not say that the popular press or press releases are primary sources, or secondary sources." Remember, we should not engage into original research and re-write conventional definitions of secondary and primary sources. No examples of expert support of the questionable definitions has been given in this discussion in spite my repeated requests and questions.Paul Gene (talk) 00:53, 30 August 2008 (UTC)


 * The text you deleted has so far, been questioned only by you. It is stable text, and has been in the article in its current form for over a year. It is not a definition; it is advice from experienced Wikipedia editors. It does not say that press releases or the popular press are secondary sources; it says that the secondary source material in press releases and the popular press tends to be less useful than the other secondary sources mentioned (e.g., refereed articles in medical journals). This is widespread consensus among experienced editors of medical articles. Certainly I find it to be true: for example, this article in the Washington Post is far less useful than this article in the Annual Review of Public Health; they are both dated 2007 and they both talk about the epidemiology of autism, but the medical-journal review article is way, waay, waaay more informative and reliable. Eubulides (talk) 01:58, 30 August 2008 (UTC)


 * Eubulides,


 * (1) It is not true that Paul Gene is the only one who questions (actually, objects) to that text. I also object to it.


 * (2) I've known Ed Edelson for many years, since he was science reporter for the New York Daily News, and I'm familiar with his work. I think this Washington Post story on the rise in autism is a good, useful story. It's a good report of what experts said at a meeting, and it gets a range of authoritative views. You have not expressed any objection to it on the merits. You have merely used it to support your personal opinion that you don't like newspaper medical stories.


 * You don't define "useful." The Washington Post story is free on line. The Annual Reviews article is not. Unless Wikipedia editors have a subscription to Annual Reviews, they can't access it. That violates WP:VERIFY. A source that is inaccessable and cannot be verified is not useful.


 * You have provided no evidence that newspaper articles are less "useful" than academic reviews. In fact, you've provided evidence against it. I propose, based on your own comparison of Washington Post to Annual Reviews, that newspapers do provide useful material, and therefore we should delete the incorrect text as Paul Gene did.Nbauman (talk) 18:10, 30 August 2008 (UTC)


 * Your claim that offline and non-free sources fail WP:V is nonsense. There is not one word in that policy that says we cannot cite journals that would require either a paid subscription or a trip to the library.  WhatamIdoing (talk) 00:23, 31 August 2008 (UTC)


 * The question is whether newspapers are "useful". Eubulides doesn't define the term "useful", and he has not cited anything in the Washington Post story that is wrong, nor given any reason why it or similar articles should not be used in a WP article. I think it's clearly useful, in the ordinary sense of the term. I would like to see Eubulides's specific criticism of the article. So far, he hasn't given us one.


 * I agree that peer-review subscription-only articles should be used, and are usually more reliable, although that has the problems of WP:LINKS Sites requiring registration. The question is whether newspapers should also be used.


 * I would like to see a good, logical argument for why newspapers should not be used. So far, nobody has given us one. Nbauman (talk)


 * While we're wishing, I'd like to know how many times WP:EL has to state The subject of this guideline is external links that are not citations of article sources and This guideline does not apply to inline citations, which appear in the "References" or "Notes" section and A site that requires registration or a subscription should not be linked unless...[it] is being used as an inline reference (and so forth) before editors will realize that it does not apply to references. May I encourage you to read both paragraphs in the section you linked?  WhatamIdoing (talk) 20:56, 31 August 2008 (UTC)

Newspapers
''Journalists, writing in the popular press, and corporate press releases tend to provide less useful secondary source material. Such material may be appropriate for inclusion in some contexts.''

As a journalist, I disagree with that statement, and I agree with Paul gene that "This defintion is questionable and OR. You have to present evidence in its favor before including it.

I'd like to know why somebody made deletions in the following paragraph. I didn't see anything about this in the history or my watch list, so I didn't realize it had been deleted.. This is a WP:RS authoritiative academic review of the quality of newspapers, as distinct from an editor's personal opinion.

''Newspapers

''The quality of newspaper coverage of medicine ranges from excellent to irresponsible, and they should be verified like any other sources. Even peer-reviewed journals like the New England Journal of Medicine cite articles in newspapers like the New York Times and Wall Street Journal. Some tabloids, like the New York Daily News, have a reputation for careful fact-checking and knowledgeable reporters; others do not. Newspapers should be judged on the facts, not on prejudices. Some academic organizations that evaluate news coverage are Health News Review (U.S.), Media Doctor (Australia), and Media Doctor (Canada). The British Medical Journal reviews U.K. media coverage.''

Nbauman (talk) 01:24, 30 August 2008 (UTC)


 * The material in question was deleted in this edit with the comment "keep it simple", a sentiment I tend to agree with. This should be a guideline, not an academic paper studded with citations. Besides, the longer text is self-contradictory: "Newspapers should be judged on the facts, not on prejudices." collides with "Some tabloids, like the New York Daily News, have a reputation...." Let's just keep it simple and say "quality newspapers". Eubulides (talk) 01:58, 30 August 2008 (UTC)


 * We've been round this debate already. See the archive. Newspapers simply aren't designed to be source material for medical or science articles in an encyclopaedia. I really struggle to understand how you think they are. And for anyone who thinks the UK press should be used as a source for medical facts I suggest you read today's article by Ben Goldacre in The Guardian. Colin°Talk 12:56, 30 August 2008 (UTC)


 * Wikipedia should be simple, but we must follow WP rules of verifiability, WP:RS and WP:NPOV.


 * The statements about newspapers in the present articles are WP:OR, personal opinion, unsourced and not verifiable. The deleted text is an academic and professional consensus, supported by verifiable WP:RS and academic research and authority.


 * We did have a debate about this before. Your argument was to cite selected examples of newspaper stories that, in your opinion, were wrong in some way. My argument was to cite international academic studies such as Health News Review, which you deleted.


 * In Wikipedia, the personal opinion of one or a few editors can't prevail against verifiable WP:RS and WP:NPOV.


 * Whether you like it or not, Wikipedia editors use newspaper articles extensively to write and source WP articles. If you read the daily newspapers, and also the medical journals, as I do, you can see that the medical facts in newspaper stories are often more accurate than the facts in some journal articles, as the medical journals themselves often admit in retrospect (for example the NEJM articles on VIOXX). So if you accept major peer-review articles as reliable sources, you must accept their conclusions that newspapers can be reliable.


 * Since Wikipedia editors do use newspapers, this guideline should give them specific guidance about how to evaluate newspaper stories -- a vague statement about "quality newspapers" is useless, since it merely transfers the argument to whether a given newspaper is "quality." Why not tell them how to use WP:RS to decide for themselves whether a newspaper is quality?


 * Our responsibility here is to elaborate on WP:RS for medicine. Medicine is a specialty, with specialized rules, and particularly complicated information sources. We should give them useful, helpful guidance, from available academic sources, to decide for themselves, not just tell them to follow the authority of "our" peer-reviewed literature.


 * Wikipedians use newspapers as sources for WP articles because most people don't have access to the academic, subscription-only sources that you presumably do. This guideline could be harmful if pedantic editors use this as an excuse to delete good newspaper stories as sources, and replace them with subscription-only sources that ordinary readers can't verify, which would violate WP:VERIFY.


 * To address Colin, I would like to know how you support the claim that newspapers "aren't designed to be source material for medical or science articles in an encyclopedia." I work for newspapers, and we are aware that we have many readers who use our stories for many purposes. I also know people who worked for encyclopedias and reference books. They would certainly accept a Wall Street Journal or New York Times story for fact-checking purposes.


 * As for Ben Goldacre's story in the Guardian, first I would point out that you're contradicting yourself. You say that newspapers are not a source for medical facts. But you are using Goldacre's story yourself as a source for medical facts.


 * Second, if Goldacre is correct, the debunked link between MMR and autism was published in peer-reviewed journals, including review articles. So some newspaper stories (including Goldacre's) were more reliable than peer-reviewed journals.


 * Third, Goldacre says that the anti-MMR lobby targeted general journalists, rather than health or science correspondents (such as himself). This supports the conclusions of Health News Review, which you deleted.


 * But the fundamental problem is that you're simply citing a single example (published in a newspaper at that). You need more than a data point of 1 to prove your point. If you really believe what you're saying, then go to the peer-reviewed academic communications literature, as I did, and see what they say.


 * In short, the statements about newspapers in this entry are personal opinion, and wrong. You are deleting authoritiative, WP:RS, useful information that will help editors evaluate the reliability of newspapers for themselves. Nbauman (talk) 15:20, 30 August 2008 (UTC)


 * Contrary to the apparent beliefs of two editors, NPOV and NOR apply to articles, not guidelines created for internal use. Guidelines are not required to cite their sources, to find independent, third-party publications to support their claims, or to fairly present anything at all.  They are, indeed, permitted to stand strongly against deprecated practices, to oppose things deemed undesirable, to announce good practices, and to base themselves entirely on original research.  (Just the other week, WP:LAYOUT was counting up the relative proportion of articles using different headings for references in an effort to make a decision, which is clearly "original research".)
 * When a newspaper story reports a publication, then a responsible science editor will double-check the newspaper reporter's understanding by looking up the actual publication instead of blithely assuming that every single reporter always gets every single scientific fact correct the first time. (Nbauman, do you assert that you have never published a single factual error?)  WhatamIdoing (talk) 00:35, 31 August 2008 (UTC)


 * Somehow this discussion has overspilled from the previous topic. Thank you, WhatamIdoing for raising a good argument. This is the kind of discussion I would like to have in this space. Paul Gene (talk) 11:49, 31 August 2008 (UTC)
 * And I concede you this point. It is then my original research (which I of course believe is better ;) ) vs. Eubulides's. It is then my and Nbauman's opinion vs. yours, Eubulides's, Sandy's and other editors. Then, we have reasonable people like Colin, who would not mind not having newspapers and press releases mentioned in the definition of secondary sources. It is also a poor style to include something which is often a primary source (as I believe everybody agrees) into the definition of the secondary source. I would suggest as a compromise option either deleting or moving this sentence from the definition part to Avoid citing popular press, which it anyways duplicates. Paul Gene (talk) 11:49, 31 August 2008 (UTC)


 * I just realized from the other discussion that this is a guideline, and should not be changed without discussion and consensus in Talk. The text about Health News Reviews was added by consensus and has been in the guideline for over a year without objection.


 * The burden of proof is not upon me to gain a consensus that the text about Health News Reviews should be restored; the burden of proof is upon Colin to gain a consensus that it should be removed.


 * I am restoring the text. If anyone wants to delete it, please discuss your reasons here and get consensus. Nbauman (talk)


 * I have made an edit regarding press releases that should keep Paul happy. I've moved mention of it down to the Popular press section.


 * As for Nbauman's comment: This isn't a guideline (yet) and there is no rule on WP that all edits to guidelines require discussion and consensus in Talk. Nbauman's text was originally added against consensus (as can be see on the archive) and was much discussed already. Life is too short to repeat all that, I'm afraid. Nbauman continues to misunderstand the word "reliable" and continues to cite the current-affair/investigative journalism example of Vioxx. Nbauman provided the example of a good pop press article, not me (Bell Curve). It was then promptly destroyed as a good source for WP. Goldacre was cited not for his medical facts, but his article on newspapers. Is it so hard to understand that newspapers are good for some things and not others? I don't think the English Literature wikiproject has this trouble, or the Mathematics wikiproject, etc, etc. Other WP:MED editors, feel free to remove the offending text. Colin°Talk 14:24, 31 August 2008 (UTC)


 * Nbauman, I would be most happy if WP cited newspapers for their medical facts with precisely the same frequency as "the New England Journal of Medicine cite[s] articles in newspapers like the New York Times and Wall Street Journal.". That would improve the quality of our medical articles immensely. Colin°Talk 15:23, 31 August 2008 (UTC)

No consensus for text about newspapers
I went back and read the records, and did not find support for Nbauman's claim "The text about Health News Reviews was added by consensus". Nbauman's original edit, which added this material in April 2007, was clearly controversial at the time. Newspapers, the first thread about it, had commentary by three editors, only one of whom (Nbauman) favored the change. Avoid citing the popular press had commentary by the same three editors, with the same results. Not ready for guidelines (May 2007), the only thread that explicitly mentions Health News Review, has commentary by four editors; again, only one (Nbauman) favored inclusion of such material. What appears to have happened is that a single editor tirelessly advocated the change and installed it without consensus.

Given all this history, along with the discussion above, I'm inclined to revert the controversial edit. The text in that edit sticks out like a sore thumb: it's argumentative, it gives a mistaken impression to unwary readers that the New York Daily News is in the same ballpark as the New England Journal of Medicine for reliability, and basically it encourages Wikipedia editors to substitute newspaper articles for medical-journal articles if they think the newspaper is reliable. Eubulides (talk) 19:17, 31 August 2008 (UTC)

Proposed replacement for Newspapers
I am not opposed to mentioning Health News Review, but it needs to be placed in context better. There are specialized journals such as Journal of Health Communication and Health Communication, but the best coverage of how media covers tends to appear all over the place, in journals ranging from the American Journal of Disaster Medicine (e.g., see Gionis et al. 2007, ) to the American Journal of Public Health (e.g., see Wenger et al. 2001, ). So, after reverting, I propose replacing the contents of WP:MEDRS with the following text.


 * The quality of newspaper coverage of medicine ranges from excellent to irresponsible. Quality newspapers can make a good source for social, biographical, current-affairs and historical information in a medical article. However, medical facts and figures should be sourced to medical journal articles, perhaps with an additional citation to a free newspaper source for the benefit of readers who lack access to medical journals; one way to do this is with the "laysummary=" parameter of the Cite journal template. Sources for evaluating health-care media coverage include Health News Review, Health Communication, and the Journal of Health Communication; the best reviews of media coverage often appear in more-general sources such as the American Journal of Public Health and The Guardian.

Further comments are welcome, of course. Eubulides (talk) 19:17, 31 August 2008 (UTC)


 * (An updated version of this draft is in below). Eubulides (talk) 08:46, 1 September 2008 (UTC)


 * First, clarify "more-general." I read or have read several of the major peer reviewed journals, and they all have occasional articles about the media, and while useful, they only cover one specific topic at a time, and do it irregularly. Health News Review and its sister journals, which are also peer-reviewed, cover the media regularly. In that sense they are more-general sources. I don't understand what you mean by saying that AJPH and The Guardian are "more-general."


 * Second, I don't mind mentioning The Guardian, which I read sometimes, but (1) do they have much analysis of medical news besides Goldacre? (2) The Guardian isn't peer-reviewed, like Health News Review, and to me that makes a big difference. Nbauman (talk) 20:37, 31 August 2008 (UTC)


 * I changed "more-general" to "other" in below.
 * I mentioned The Guardian only because it came up in earlier discussion here. It's nice to mention a non-U.S. source, but if there's a preference to mention some other source that'd be fine too.
 * I'd rather mention at least one non-peer-reviewed source in the list; some of the best work in this area (such as Goldacre's) is not peer-reviewed.
 * Eubulides (talk) 08:46, 1 September 2008 (UTC)


 * The statement "medical facts and figures should be sourced to medical journal articles" is too restrictive and not required given the reset of this proto-guideline. I think the lay summary suggestion is good, though the text needs a little work. Even readers who have access may wish a easy-to-digest version as WP is written for the general reader. In fact, this is one area where a press release might be useful (see discussion below).


 * I'm not sure what the "sources evaluating health-care media coverage" has to do with WP:MEDRS. By all means summarise their conclusions in this guideline. To answer Nbauman, Goldacre's remit in the Guardian is the discussion of bad science, usually wrt medicine. This often discusses the bad reporting of bad science in newspapers. His work is accessible and may be an eye-opener for some, but it is certainly an opinion-piece rather than a work of scholarly analysis. I'm not aware that any UK newspaper has a qualified full time science or medical reporter let alone anyone capable of editing such articles. Even good quality medical articles are mediocre sources for WP -- see the Bell Curve example in the archive. A good quality lay medical article can be well worth reading, in order to work out how to discuss the topic in lay terms. Colin°Talk 20:55, 31 August 2008 (UTC)


 * In below, I changed "medical facts and figures should be sourced to medical journal articles" to "They should not be used as a sole source for medical facts and figures", which is nearly what is there now (with the addition of a "sole").
 * Now that you mention it, the "sources evaluating health-care media coverage" stuff seems to be more relevant to WP:MEDRS than to WP:MEDRS . I revised the proposal to summarize their results in WP:MEDRS, and to move the "sources evaluating health-care medica coverage]] stuff to the other section.
 * Eubulides (talk) 08:46, 1 September 2008 (UTC)


 * In general I like this approach. However, I'd change However, medical facts and figures should be sourced to medical journal articles, perhaps with an additional citation to a free newspaper source to be less specific.
 * Medical facts can be properly sourced not just to journal articles, but also to college-level (and higher) textbooks and other reputable reference works (i.e., Gray's Anatomy). This expansion is particularly important for facts involving basic science.
 * Similarly, newspapers are not the only possible source of open-access information: there are many highly reputable health-related websites that might be at least as appropriate (*.cdc.gov, for example).  Additionally, I'm happy to see good, open-access media articles listed in the ==External links==, which is another way to put lay-language information into the hands of interested readers.  WhatamIdoing (talk) 21:16, 31 August 2008 (UTC)


 * below changes the "medical facts and figures" text along the lines you suggest. I prefer to reserve External links for websites and the like, and to cite open-access media articles as usual with citations, except with a URL so that the reader can easily see that the media articles are freely readable (but surely this is a style issue?). Eubulides (talk) 08:46, 1 September 2008 (UTC)

Proposed replacement for Newspapers 2 etc.
With all the above in mind, here is a revised proposal for replacement for WP:MEDRS :


 * The quality of newspaper coverage of medicine ranges from excellent to irresponsible. Quality newspapers can make a good source for social, biographical, current-affairs and historical information in a medical article. However, most news articles fail to discuss important issues such as evidence quality, costs, and risks versus benefits, and should not be used as a sole source for medical facts and figures. One possibility is to cite a higher-quality source along with a more-accessible newspaper source, for example with the "laysummary=" parameter of the Cite journal template.

And here is proposed additional text to be appended to the last paragraph of WP:MEDRS :


 * Sources for evaluating health-care media coverage include Health News Review, Health Communication, and the Journal of Health Communication; the best reviews of media coverage often appear in other sources such as the American Journal of Public Health, Columbia Journalism Review, and The Guardian.


 * (Please see a proposed further revision below.) Eubulides (talk) 21:02, 1 September 2008 (UTC)

(This latter text wikilinks to a Health News Review article I just created.) Again, comments are welcome.

Eubulides (talk) 08:46, 1 September 2008 (UTC)


 * I think this addresses all the issues. Great writing! Paul Gene (talk) 09:17, 1 September 2008 (UTC)


 * (1) Along with Health News Review (U.S.), I included Media Doctor (Australia), and Media Doctor (Canada), to make it less U.S.-centric.


 * (2) I don't understand why you cite Health News Reviews, and then say that "the best reviews of media coverage" often appear in other sources. That says that HNR is not publishing "the best," while the others are. HNR's only job is to regularly evaluate health news, by a structured peer review process that includes medical doctors and journalists. I think that evaluation which is peer-reviewed is better than evaluation that is not peer reviewed. Do you disagree? If anything, HNR is "the best"; I wouldn't single it out but I would like to know why you single out the others as "the best."


 * As far as I know, the only reporting on health coverage in Columbia Journalism Review is by Trudy Lieberman (which is very good, but not peer reviewed). Can you cite anything else? The only reporting on health coverage in The Guardian is by Goldacre (which is not peer reviewed). Can you cite anything else? Nbauman (talk) 16:02, 1 September 2008 (UTC)


 * We don't have room to list all such sources. One example of each major type should be enough. Come to think of it, this should be worded more clearly; please see below.
 * The definition of "the best" depends on what kind of review one is looking for. Goldacre's column, cited above, is very high in quality, but as far as I know broad-scope coverage like that is not published in Health News Review.
 * Although Health News Review has a team that produces high-quality reviews, these reviews are not themselves peer-reviewed, as far as I can see. This is in contrast to peer-reviewed publications such as the Journal of Health Communication and the American Journal of Public Health. That being said, I agree that "the best" doesn't need to appear here.
 * With the above in mind, here's an updated version of the "Sources for" sentence.
 * Sources for evaluating health-care media coverage include review websites such as Health News Review and specialized academic journals such as the Journal of Health Communication; high-quality reviews can also appear in sources as various as the American Journal of Public Health, the Columbia Journalism Review, and The Guardian.

Eubulides (talk) 21:02, 1 September 2008 (UTC)


 * If space is a consideration and we don't have room for the Australian and Canadian reviews, then we should shorten it to:


 * Sources for evaluating health-care media coverage include review websites such as Health News Review and specialized academic journals such as the Journal of Health Communication; reviews can also appear in the American Journal of Public Health, the Columbia Journalism Review, The Guardian, and others.


 * Nbauman (talk) 04:22, 2 September 2008 (UTC)


 * Yes, that'd be fine. Eubulides (talk) 05:16, 2 September 2008 (UTC)


 * With respect to the following:


 * Quality newspapers can make a good source for social, biographical, current-affairs and historical information in a medical article. However, most news articles fail to discuss important issues such as evidence quality, costs, and risks versus benefits, and should not be used as a sole source for medical facts and figures.


 * I'd like to know the evidence you have to support the statement that "most news articles fail to discuss important issues such as evidence quality, costs, and risks versus benefits."


 * I think we all agree that 'some news articles do discuss exactly those issues, and some do not. For example, Health News Reviews evaluated the New York Times article on HPV vaccines, and it covered all those issues and more. Health News Reviews found many more articles that met those issues.


 * On the evidence of Health News Reviews and other sources, we can say that some news articles fail to discuss those things, but I want to know the evidence for saying most.


 * As I understand it, this is based on the personal opinion of several editors. Is it based on anything else? Nbauman (talk) 17:02, 2 September 2008 (UTC)


 * That was not based on my (or other Wikipedia editors') opinion. It was based on Schwitzer 2008, a source cited in the Health News Review article. That source's summary says "journalists usually fail to discuss costs, the quality of the evidence, the existence of alternative options, and the absolute magnitude of potential benefits and harms." Eubulides (talk) 17:31, 2 September 2008 (UTC)


 * Additionally, that statement appears to line up with everyone's experience (except perhaps for our professional journalist's) and this guideline is not an encyclopedia article. We do not actually have to provide reliable sources to support statements that we all agree on.  The newspaper-seller's apparent horror of absolute risks drives me nuts.  "Risk tripled!" the headline trumpets -- but never mentions that it's from 1 in 30,000 to 1 in 10,000.  WhatamIdoing (talk) 17:58, 2 September 2008 (UTC)


 * Very good. That's a good source, open source, and an important point. I'm glad I pressed you on it. I think we should include the source. It doesn't lengthen the body of the text significantly to insert a footnote, and it increases the reliability and authority infinitely.


 * WhatamIdoing, could you or somebody else help me out? Could you link to the WP rule that says that factual statements in guidelines are exceptions to WP:RS? Nbauman (talk) 19:10, 2 September 2008 (UTC)


 * Content policies and guidelines apply to article space (i.e. the encyclopaedia). Read any one of them and you'll see the word "articles" repeated again and again. The policy and guideline pages, along with talk pages, user and project pages are all part of the machinery but not the product. The overriding rule for policy and guidelines is that the text is achieved through consensus. Colin°Talk 19:40, 2 September 2008 (UTC)


 * Thank you, Colin. Can you link to an official statement in Wikipedia that says that? Nbauman (talk) 22:59, 2 September 2008 (UTC)
 * I can: First sentence, second paragraph of WP:RS:  "Wikipedia articles should use reliable, third-party, published sources."  Or let us have the third sentence of the second paragraph at WP:V:  "Jointly, these policies determine the type and quality of material that is acceptable in Wikipedia articles."
 * So it appears that RS and V apply solely to articles. If you want to be WP:POINTy about it, let me suggest that you take it up at Village pump (policy).  I suggest that you start by telling them that you think that the provisions of WP:V itself need to meet WP:V.  WhatamIdoing (talk) 00:19, 3 September 2008 (UTC)


 * WhatamIdoing and Colin, I believe that when WP:RS refers to "articles", that includes guidelines and policy statements insofar as the guidelines and policy statements refer to facts.


 * You believe WP:RS excludes guidelines and policy statements.


 * However, neither you nor anybody else can cite with a link any WP guideline or policy statement that explicitly supports your belief.


 * Is that correct? I just wanted to get that on the record. Thanks. Nbauman (talk) 09:10, 3 September 2008 (UTC)


 * "Policy change comes from three sources: 1.Documenting actual good practices and seeking consensus that the documentation truly reflects them." Policies and guidelines Paul Gene (talk) 09:56, 3 September 2008 (UTC)
 * Nbauman, WP's content guidelines and policies explicitly apply to articles and don't need an explicit exclusion for the other parts of WP (which aren't articles) in much the same way that the Highway Code doesn't contain an exclusion for aircraft or boats. Colin°Talk 12:20, 3 September 2008 (UTC)
 * Colin, my question was, is your contention that facts in guidelines do not require WP:RS (1) based on your own personal determination of what is common sense, or is it (2) based on an explicit WP rule that you can cite with a link. Your answer is therefore (1). Nbauman (talk) 16:59, 3 September 2008 (UTC)


 * For the record, I draw your attention to Wikipedia:Verifiability WP:V: "This page in a nutshell: Material challenged or likely to be challenged, and all quotations, must be attributed to a reliable, published source."


 * It doesn't distinguish between articles, guidelines, or anything else on WP, it just says "material."


 * So I think WP:V clearly states that any material challenged must be attributed to a reliable, published source -- including factual material incorporated into guidelines. Nbauman (talk) 18:11, 4 September 2008 (UTC)


 * This interpretation of WP:V is contradicted by material that is present in WP:V itself. For example, WP:V says "In general, the most reliable sources are peer-reviewed journals and books published in university presses". This is a factual claim, that is likely to be challenged using exactly the sort of challenges that we're seeing for WP:MEDRS. But WP:V does not cite a source for this claim. And the claim is not an isolated example: there are several such claims in WP:V, and none of them cite a source. Similiarly, WP:RS (which is a generalization of WP:MEDRS) cites zero sources for its several claims. Eubulides (talk) 19:30, 4 September 2008 (UTC)


 * WP:V's lead text says "Verifiability is one of Wikipedia's core content policies. The others are No original research and Neutral point of view. Jointly, these policies determine the type and quality of material that is acceptable in Wikipedia articles." Note that last word. This is beyond tiresome. Colin°Talk 20:01, 4 September 2008 (UTC)


 * I'm not convinced. I think the statement, that peer-reviewed journals and university presses are reliable, is so generally accepted that it does not require a WP:RS. However, the statement that newspapers usually have those flaws is not generally accepted, so it requires a source.


 * I don't want to argue about it forever. However, I do want to insert the source into that statement about newspapers. I think that's a reasonable compromise. One more footnote won't detract from the article. Nbauman (talk) 02:32, 6 September 2008 (UTC)

OK, there seems to be some consensus for the revised proposed text, as far as it goes, so I installed it. One minor wording change as I installed it: I changed "and should not be used" to "and news articles should not be used", to prevent a plausible misreading of the phrase to mean "and most news articles should not be used", a meaning which differed from the previous meaning and was not the intent. Eubulides (talk) 07:32, 3 September 2008 (UTC)


 * I have to throw in a few pennies, here. I think that anywhere on Wikipedia a statement is presented as fact, the factuality of that statement should be open to question, and if necessary those questions ought to be met with proper sourcing.  even in policy and guidelines...  in this case (it seems to me) Nbauman is objecting to what seems like a prejudicial statement against newspapers being presented as fact, and I'm not convinced he's wrong - wp:RS would seem to be on his side.  I'm not sure that I would personally disagree with you that some newspaper articles on medicine are poor quality, mind you, but I can't really see how we can make that judgement as editors - on a case by case basis, or in total - without violating wp:SYN.  I think this passage ought to be reverted while we discuss the matter a bit more.  -- Ludwigs 2  00:16, 6 September 2008 (UTC)


 * I think we can reach consensus by adding the citation to support this claim: "However, most news articles fail to discuss important issues such as evidence quality, costs, and risks versus benefits." I don't think we have consensus otherwise. Without the citation, it sounds like some editor's personal opinion and cranky anti-media bias. Nbauman (talk) 02:24, 6 September 2008 (UTC)
 * If you want to add a citation to back up what has already been agreed by the consensus of WP editors, then that is fine. I have no problem with that. The point we are making is that such citations are not required and WP could, if it wants to, collectively disagree with outside opinions (e.g., that lay people can make a useful contribution to a scholarly encyclopaedia :-) Colin°Talk 10:32, 6 September 2008 (UTC)

I'd still be happier

 * I'd till be happier if this section were not so anti-newspaper. a newspaper is a reliable source, and it should always be assumed that a newspaper article has done appropriate fact checking to present a credible viewpoint.  the objection that they don't present certain scientific facts is really more a concern for people doing primary research; it should not matter to a tertiariy source like wikipedia, and excluding newspaper articles on that basis is no justified.  let me see if I can make a corrective edit.  -- Ludwigs 2  21:47, 7 September 2008 (UTC)

Unfortunately the change you installed (without previous discussion) had serious problems. Here's what the change was:
 * However, most many news articles fail to discuss important scientific issues such as evidence quality, costs, and risks versus benefits, and a news article should not be used as a sole source for a medical fact or figure. One possibility is to cite a higher-quality source along with a more-accessible newspaper source, and should generally be supplemented with academic secondary sources, for example with the "laysummary=" parameter of the Cite journal template.

Some problems with this: There is one change, the addition of the word scientific, which is not a serious problem, though I don't see why it's needed here. For now, because of the serious problems mentioned above, I reverted the change. Eubulides (talk) 23:16, 7 September 2008 (UTC)
 * It changes "most" to "many". But "most" is accurate; see Schwitzer 2008 . It should not be watered down to "many".
 * It removes mention of quality, costs, and risks versus benefits, but these are important and relevant issues, which Schwitzer mentions.
 * It removes longstanding advice in this article that news articles should not be sources for medical facts and figures.
 * It has things backwards, by suggesting that newspapers be the main source, with refereed journal articles being supplements. The more-reliable sources should be the main sources.
 * it was a first draft, and I didn't expect it to be perfect. the main problem I have here is that you all seem to have unilaterally decided that [wp:RS#News_organizations]] does not apply to medicine articles.  you seem to have decided this because you are (unfairly) equating newspaper articles in toto to poor quality newspaper articles.  It might be advisable to do this on a case by case basis - possibly news articles require more careful vetting - but writing them off in advance as poor-quality sources is clearly against established policy.  If you don't like my changes, that's cool, but how do we modify this passage to keep it in line with policy? -- Ludwigs 2  23:46, 7 September 2008 (UTC)
 * WP:RS is a guideline; it's not policy. The WP:MEDRS advice to not source medical facts and figures from newspapers has been in the page for a long time and seems to represent a working consensus here. It is appropriate to have a stricter guideline for biomedical topics. It's probably better to discuss drafts like that here first, before installing them; perhaps you could draft a proposed improvement with the above comments in mind? Eubulides (talk) 00:11, 8 September 2008 (UTC)
 * I've not seen a newspaper account of Tourette syndrome yet that was correct. Not one.  No reason to prefer them when we have peer-reviewed sources.  After viewing Ludwigs2's editing to WP:NPOV, I'm concerned about the effort to diminish NPOV and high quality sources.  Sandy Georgia  (Talk) 00:13, 8 September 2008 (UTC)
 * don't make this personal, Sandy. if you want to debate the value of particular edits, that's fine, but if you want to criticize my understanding or intent then you're way off-base (because - frankly - you really don't have the faintest idea what's going through my mind; if you did, you wouldn't be so quick to cast aspersions).  let's try to keep things on track, ok?  -- Ludwigs 2  20:28, 8 September 2008 (UTC)
 * WP:RS used to explicitly warn against using the popular press as a source for science. The remnants of that advice can be found in Reliable source examples, which is just an essay. Regardless, both WP:V and WP:RS place an emphasis on scholarly works as sources. A quality newspaper is a vital reliable source for "news" (current affairs) and serves as a historical record of such events. It should no more be considered a reliable source for medical facts, than my Radio Times is a reliable source on Jane Austen. Colin°Talk 08:47, 8 September 2008 (UTC)
 * I don't know what RS used to say, and I'm not trying to rest this discussion on what RS currently says (because, yes, policies change over time). to my mind, what reliable sourcing means is that sources provide informations which we can trust to be factually correct depictions of common knowledge in a field.  academic journals and other scholarly sources are generally factually accurate, but they often lean towards primary research (and thus are not reflections of 'common knowledge').  newspapers reflect common knowledge well, but are not as factually accurate (in part because they are not peer reviewed, and in part because they focus on different facts than scientists do).  do you think that's a bad assessment? -- Ludwigs 2  20:41, 8 September 2008 (UTC)
 * Again, WP:RS is a guideline, not policy. In my experience, the "common knowledge" about medical facts and figures that newspapers express but academic sources do not would be more-accurately characterized as "folk theories", or "speculation". For example, popular coverage on the causes of autism focuses heavily on environmental theories, which are are popular among non-experts but are quite speculative; in contrast, popular coverage tends to deemphasize genetic theories, which have a strong consensus among experts (see Singh et al. 2007, ). Eubulides (talk) 21:20, 8 September 2008 (UTC)

Controversies
I haven't been following the discussion very closely, so correct me if I've overlooked something. I assume the RS we're talking about are mostly concerned with dealing with scientific facts, in which case we want to use the best sources available, such as peer reviewed research, etc. Well, medical subjects, which (unfortunately) includes alternative medicine and other forms of quackery and health fraud, involves much controversy and there are numerous commentaries from mainstream sources, but such commentaries don't usually appear in peer-reviewed research. Such commentaries will also deal with the medical politics, turf wars, etc., which are also matters not usually dealt with in peer-reviewed research. Wikipedia's NPOV policy requires that we tell the whole story, and thus these controversies will need to be mentioned in medical and scientific articles. We will need to use non-peer-reviewed commentaries. Have you been dealing with this issue at all here? -- Fyslee / talk 19:50, 31 August 2008 (UTC)


 * So far the proposals have not explicitly addressed that situation; instead, they give generic advice that ideally would apply to alternative-medicine topics just as well as to mainstream-medicine. In Chiropractic I've found quite a few sources about medical politics etc. in peer-reviewed articles. That may be a special case, but at any rate the current guidelines don't advise against using non-peer-reviewed commentaries in that case, they merely advise not to use the popular press for medical facts and figures. So, although WP:MEDRS doesn't offer much guidance in your situation, it doesn't suggest not using the popular press either. Is that good enough for now? Eubulides (talk) 08:46, 1 September 2008 (UTC)

Press releases
Since I've used and fact-checked press releases extensively, and occasionally written press releases, I know the mechanics of writing a press release, and I can contribute some facts to the discussion.

Press releases represent the institution that issues the press release, and they are as reliable as that institution.

Peer-reviewed journals like BMJ, Lancet, JAMA, Science and Nature issue press releases, which are approved by both the editors of the journal and the authors of the papers. I think we can agree that those PRs are as reliable as the journals.

Universities issue press releases, and when they are about scientific subjects, usually in peer-reviewed journals, they are reviewed by the investigators who did the work, so they are as reliable as the investigator and usually as reliable as the journal article itself.

Book publishers issue press releases. Since they are reviewed by the author, they are as reliable as the author. (So saying "Press releases are accurate" is like saying "Books are accurate.")

Major pharmaceutical companies issue press releases, which are reviewed by their legal departments; they have to meet many legal requirements including FDA labeling restrictions and securities laws requirements. Corporations would be vulnerable to legal actions and damages if they knowingly printed inaccurate information, so they are usually literally accurate, although they can also be promotional and are not as objective as peer-reviewed journals. They're works of advocacy, which is not the same as the whole truth. If the pharmaceutical company wants to tell the whole truth, which they sometimes do, they'll give the benefits and the limitations of a new drug.

Finally, anybody can issue a press release. Any nut with a 50kg drum of DHEA and a pill press can put out a press release touting the benefits of DHEA. So it's hard to generalize about press releases and they have to be taken on their merits.

I see press releases, and then see the stories that are written about them in the newspapers and elsewhere. First, the wire services take about 10% of the medical press releases and run them pretty much as is. (Science Daily seems to be entirely compiled from press releases.) Then, if a story is particularly important or controversial, they'll do some fact checking and get comments (as Edward Edelson checked the meeting presentations in that Washington Post story.) Major newspapers like the New York Times and Guardian treat press releases that same way.

Sometimes the news sources get it wrong and the original press release is more accurate. Sometimes the news sources add useful perspectives to the story. Many science reporters have PhDs and MDs (for example Robert Altman of the New York Times) so their stories can often be more reliable and accurate than the original peer-reviewed journal article.

The main function of a press release is to explain the scientific publication in language that a non-specialist reader can understand. (Wikipedia is also written for a non-specialist audience.) Scientific journals have certain conventions which make them hard to understand, such as using technical language and putting the conclusion at the end. Press releases explain technical terms (as WP should) and put the conclusion at the beginning. They usually know that laymen will frequently misinterpret certain things from journal articles, so press releases should (but don't always) articulate those points clearly, for example that a study has only been done in vitro.

Significantly, press releases are designed to be copied, so under the copyright laws "fair use" would be very broadly interpreted.

Furthermore, they often contain the significant content of a subscription-only journal article, in a form that is reliable and less subject to misinterpretation than the free abstract and sometimes the article itself.

For these reasons, I think that press releases from reliable sources are a good WP:RS for Wikipedia, in addition to the link to the PubMed or original article. Press releases are open access, and you can check them to make sure an editor didn't misunderstand or distort the original article.

That's why I also think that press releases that have gone through an additional layer of fact-checking, and published as news stories in a reliable newspaper, are also good WP:RS, in addition to peer-reviewed sources.

Are press releases about journal articles primary or secondary sources, for Wikipedia purposes? I don't know. The main problem with primary sources is that they are subject to misinterpretation, and using them is WP:OR. Press releases are less subject to misinterpretation, because they are designed to be read by non-specialists and designed to flag common misunderstandings. So they do have that advantage and serve that purpose of secondary sources. Nbauman (talk) 20:09, 31 August 2008 (UTC)


 * All this proto-guideline currently says is that press releases "can be a biased source". They are saying "look at what we've done" or "listen to what we have to say on X". As you say, some press releases are effectively self-published sources that any crank could create. Others have a degree of editorial (or, at least, legal) oversight. Regardless, they are about as far from independent and impartial as you can get. So we need to treat them with caution. Is there anything in this guideline wrt press releases that you disagree with. I've suggested above that they may be useful as lay-summary versions of scholarly or inaccessible sources. Do you want to suggest some extra text on PRs? If so, please make it brief as the above posting was verging on TLDR. Colin°Talk 21:07, 31 August 2008 (UTC)


 * (BTW) Using primary sources isn't necessarily WP:OR. For more details, see WP:OR! Colin°Talk 21:21, 31 August 2008 (UTC)


 * Again, the fact that a press release is an open-access source does not make it a reliable source. Those two qualities are entirely unrelated.  WhatamIdoing (talk) 21:08, 31 August 2008 (UTC)


 * "Universities issue press releases, and when they are about scientific subjects, usually in peer-reviewed journals, they are reviewed by the investigators who did the work, so they are as reliable as the investigator and usually as reliable as the journal article itself. " They do not misrepresent the facts of the work, but they may well misrepresent the significance. They tend to tout the importance of the study without saying just what it is or exactly where it has been published. They are not intrinsically unreliable, but I';d never ever use one for a matter of opinion about the work. The claims in the journal article are peer-reviewed. The claims in the press release are whatever the author of the article pleases. DGG (talk) 08:12, 1 September 2008 (UTC)


 * My general experience is that a press release for a scientific study is not as good as the study it promotes. Here's an example: Autism says "A 2008 study found that compared to their peers, autistic boys have significantly thinner bones if on casein-free diets" and cites Hediger et al. 2008 . But the NIH press release for that study doesn't bother to say specifically whether that difference in thinness was statistically significant. To justify the word "significant" in Autism, one really must cite the research study, not the press release. And this is one of the better press releases I've seen; it was carefully and conservatively written and was obviously vetted by the researchers. Eubulides (talk) 08:46, 1 September 2008 (UTC)


 * I agree with Eubulides that a press release of a scientific study (from academia) often exaggerates its significance and skips on finer details. On the other hand, I agree with NBauman that corporate press releases are generally of a better quality as they avoid making any exaggerated claims for legal reasons and strictly stick to the facts for the same reasons. They often precede a peer reviewed article and may be the only information source of the new developments for quite some time. It is a bit of a paradox but corporate press releases are generally reliable and often useful sources. In regards to style, "Such articles may be based uncritically on a press release, which can be a biased source." sounds awkward, does not add any content, and can easily be deleted. I wonder if NBauman can come up with a short sentence on press releases in general to replace it. Paul Gene (talk) 09:45, 1 September 2008 (UTC)

Guideline name & location
Ok I've acted as an admin and promoted from a proposed guideline to an actual guideline (RfC closed and my thoughts above).

A quick question though, as now a guideline of wikipedia, should it remain in this a single project space or be promoted in its name & location, so loosing the subpage "/" ? Hence from Wikipedia:WikiProject Medicine/Reliable sources to (current word order might suggest Wikipedia:Medical reliable sources, but I think might be better by using the standard disambiguation convention of brackets) Wikipedia:Reliable sources (Medicine) ? David Ruben Talk 01:09, 1 September 2008 (UTC)


 * This is good news! Excellent work, everyone. I think we should stick with the standard disambiguation format. -- Fyslee / talk 01:58, 1 September 2008 (UTC)


 * MEDMOS is at Manual of Style (medicine-related articles). Perhaps this should use a parallel name.  WhatamIdoing (talk) 06:11, 1 September 2008 (UTC)


 * Agree with WhatamIdoing on David's second suggestion. Also, this page needs to link back to MEDMOS somewhere. Colin°Talk 10:32, 1 September 2008 (UTC)

To keep to bracketed disambiguation style and in keeping with MEDMOS approach, I've moved this wikiproject subpage from Wikipedia talk:WikiProject Medicine/Reliable sources to Reliable sources (medicine-related articles). We can (at this early stage) rename, but I think I prefer WhatamIdoing's suggestion to my previosu "Wikipedia:Reliable sources (Medicine)" which seems over-terse in structure. David Ruben Talk 23:57, 1 September 2008 (UTC)
 * Colin, is this what you meant for "link back to MEDMOS somewhere" ? David Ruben Talk 00:12, 2 September 2008 (UTC)


 * Just as Wikipedia talk:Reliable sources not general place to discuss specific sources (vs the overall policy), should this guideline talk page have a similar top tag-box to some form of /Noticeboard. We can either elect to point to Reliable sources/Noticeboard or create (but then have to personally watch ourselves) Reliable sources (medicine-related articles)/Noticeboard ? Feel noticeboard creep if we are not careful, so I think I would prefer the former existing RS/Noticeboard... David Ruben Talk 00:19, 2 September 2008 (UTC)


 * To be honest, I don't expect to get too many questions. The usual RSN is probably good enough, or people can leave a message at WT:MED (or WT:PHARMA, or other relevant project). WhatamIdoing (talk) 03:27, 2 September 2008 (UTC)


 * Thanks, with no further direct comments on this specific point, I've added a top banner to this talk page, pointing discussion of specific examples (vs overall guideline discussion) to RS/N (as per WP:RS's own talk page) as well as options of WT:MED & WT:PHARM. Likewise in a similar style to the last line of WP:RS's leadin, to WP:MEDRS's leadin - rephrase at will. David Ruben Talk 22:33, 8 September 2008 (UTC)


 * I left a message on David's page asking for the precedents he followed to promote this useful but extremely raw essay over the objections of significant minority of editors (3 vs 14). Paul Gene (talk) 09:59, 5 September 2008 (UTC)


 * David gave a full explanation of his reasons further up at . He specifically addresses your and Una's issue with secondary sources, and in common with most other editors finds WP:MEDRS to be in alignment with existing policies and guidelines in this regard. The other "oppose" is an outlier and can be ignored. Since both objects wrt primary vs secondary are not actionable without bringing this guideline into conflict with established policy, there seems little reason for them to block the adoption of this guideline. I'm sure this guideline can be improved and will be by collaboration and consensus. Lets work to improve it and move on. Colin°Talk 12:16, 5 September 2008 (UTC)

Assess the quality of evidence available
I'd like to see WP:MEDRS expanded along the lines of.

The primary point that I'd like to add is that if you don't have good quality evidence for a scientific or medical fact, then the Wikipedia article probably doesn't need to mention that fact. I'm sure you can all imagine a prototypical "poor evidence" scenario: an unblinded, nonrandomized, unverified, retrospective, unvalidated internet-based survey of a nonrepresentative sample of people that "proves" something.

This guideline (I think) would be a reasonable place to provide the basic advice that editors need: It's often best to omit low-quality evidence entirely, even if it means that the article is shorter or "incomplete".

What do you think? WhatamIdoing (talk) 05:42, 5 September 2008 (UTC)


 * That sounds like a rules creep to me. There are many cases when nonrandomized retrospective studies are the only sources, for example, for the rare drug effects. Another case is when such a study generates a considerable controversy and press coverage, and as such should be reflected. So, I do not see how this addition would be helpful to the editors. The overarching principles of editorial discretion and reaching consensus via discussion are sufficient to handle the situations described by What. Paul Gene (talk) 09:47, 5 September 2008 (UTC)


 * This assumes that most of medicine's decision making is founded on evidence-based medicine; it isn't. While it is useful for WP editors to have knowledge of what makes good-quality primary evidence, judging that primary evidence is really the job of someone writing a review (literature or systematic or whatever). Such a review may also make statements based on consensus opinion of experts or even from personal experience (esp. for the rare stuff that will never get a RCT). We can base our articles on such statements, even if the evidence behind them is lacking. There's also a place for opinion and supposition, if directly attributed. Colin°Talk 10:11, 5 September 2008 (UTC)


 * I'd hate to have to write an article on surgery or emergency medicine or any of dozens of other medical fields if I were limited to citing only randomized controlled trials. See, for example, Vincent 2004 "in intensive care medicine the situation is a little different, with RCT evidence frequently lacking" and Jeppsson & Thorlacius 2005  "There are several reasons for this lack of RCTs in surgery." Eubulides (talk) 16:45, 5 September 2008 (UTC)


 * I agree with Paul Gene about rules creep.


 * Evidence-based medicine is not identical to randomized controlled trials. There are many reasons why RCTs are impossible, and doctors who follow EBM acknowledge that and use the best available evidence. For example, there is no RCT to demonstrate the harmful effects of cigarettes. And there is always the period from the time of the innovation to the time of the definitive RCT, when people have to make decisions based on the best evidence. I refer you again to that "Clinical decisions" article in NEJM about skin infections. Sometimes, when you diagnose the disease specifically enough, there is no good evidence.


 * I think our job should be to explain how strong the evidence is -- where it is along the path to definitive evidence. To do that might require a bit of background on EBM. And it might require some clinical detail such as whether something is supported by prospective or retrospective trials, etc. Nbauman (talk)

Reorganize newspaper-related text
As I understand it, the two sections WP:MEDRS and WP:MEDRS  are intended to have two different functions. The former is supposed to provide basic advice about whether and how to cite the popular press, and the latter is supposed to describe the popular press's coverage of medicine-related articles. However, in reading the two sections, it appears that these two functions are not clearly separated, and material that should be in one section is put into the other (and vice versa), which is confusing. So I propose the following replacements for these two sections, with strikeouts indicating the old version and italics the new. These changes are intended to merely move text around, not to make any significant insertions or deletions. -
 * Use caution in citing the popular press
 * The popular press is generally not a reliable source for science and medicine articles. Articles in newspapers and popular magazines generally lack the context to judge experimental results. They tend to overemphasize the certainty of any result, for instance presenting a new experimental medicine as the "discovery of the cure" of a disease, or an every-day substance as the "cause" of some dreaded disease. Newspapers and magazines frequently publish articles about scientific results before those results have been peer-reviewed or reproduced by other experimenters. Such articles may be based uncritically on a press release, which can be a biased source. They also tend neither to report adequately on the scientific methodology and the experimental error, nor to express risk in meaningful terms. A news article should not be used as a sole source for a medical fact or figure. Editors are encouraged to seek out the scholarly research behind the news story. One possibility is to cite a higher-quality source along with a more-accessible newspaper source, for example with the "laysummary=" parameter of the Cite journal template.


 * On the other hand, high-quality popular press sources can be very useful in describing the sociocultural aspects of medicine, disease, and health. Common sense and the general guidelines presented in the verifiability policy and general reliable sources guideline should be considered in determining whether a popular press source is suitable for these purposes.

-
 * Newspapers
 * The quality of newspaper coverage of medicine ranges from excellent to irresponsible. Quality newspapers can make a good source for social, biographical, current-affairs and historical information in a medical article. However, most news articles fail to discuss important issues such as evidence quality, costs, and risks versus benefits, . and a news article should not be used as a sole source for a medical fact or figure. One possibility is to cite a higher-quality source along with a more-accessible newspaper source, for example with the "laysummary=" parameter of the Cite journal template. Articles in newspapers and popular magazines generally lack the context to judge experimental results. They tend to overemphasize the certainty of any result, for instance presenting a new experimental medicine as the "discovery of the cure" of a disease, or an every-day substance as the "cause" of some dreaded disease. Newspapers and magazines frequently publish articles about scientific results before those results have been peer-reviewed or reproduced by other experimenters. Such articles may be based uncritically on a press release, which can be a biased source. They also tend neither to report adequately on the scientific methodology and the experimental error, nor to express risk in meaningful terms.

- (end of proposal) Eubulides (talk) 17:30, 8 September 2008 (UTC)


 * I favour just merging the "popular press" section into one section later on (i.e., keeping it out of "Definitions and basics"). The "Periodicals" section could be split into two: "Scholarly journals" and "Popular press". The note about popular science magazines could be incorporated into the latter, along with the text on newspapers and other popular press issues. Colin°Talk 18:06, 8 September 2008 (UTC)
 * OK, thanks, a revised draft is in below. Eubulides (talk) 21:22, 8 September 2008 (UTC)


 * I think this still fails to recognize the distinction between press sources. The NYT for example is generally considered reliable for mecial coverage to the same extent as most science oriented news services. This is a little tricky though, as at present I am not aware of any other English language newspaper I would say the same about--most certainly I would no longer say this of the Guardian. DGG (talk) 18:14, 8 September 2008 (UTC)
 * The issue is not just reliability wrt medical facts, but also the suitability of the text as a scholarly source for an encyclopaedia. Can you think of a situation were, writing an FA-quality article, you would choose to cite the NYT rather than seek out a more authoritative source on medical information (excluding current affairs)? I assume you are referring to NYT articles rather than the NYT's online health guide, whose text is taken from A.D.A.M., Inc. Colin°Talk 20:07, 8 September 2008 (UTC)
 * The NYT is quite good, but even it has problems at times. Its quality ranges from Elizabeth Rosenthal's fine piece on cancer vaccines last month (HNR review) to Andrew Pollack's relatively-mediocre piece on OraVerse in May (HNR review). And if you read the reviews you'll see that even's Rosenthal's piece missed an important aspect of the HPV vaccine issue; this is something that would have been caught in a good peer-reviewed journal. Eubulides (talk) 21:22, 8 September 2008 (UTC)
 * Yes I can think of such an occasion when the researchers have a strong conflict of interest. For example, a suicide of a healthy volunteer in the duloxetine trial (see Duloxetine) has only been described in a popular press. In this case, the conflict of interests prevented the normal flow of scientific information. If it did not happen in the Lilly labs, there would have been a case study in a scientific journal. As the things stand now, the popular press is the only source of such information. Paul Gene (talk) 11:20, 9 September 2008 (UTC)

Popular press reorg 2
OK, here's a revised proposal in the light of Colin's suggestions above:


 * 1) Remove WP:MEDRS . Almost all its text will be moved to a new Popular press section as described below.
 * 2) Replace WP:MEDRS and WP:MEDRS  with a new Popular press section shown below. This section's text is taken from the current WP:MEDRS  section, with additions in italics and deletions struck out:


 * Popular press
 * The popular press is generally not a reliable source for science and medicine information in articles. Most news articles fail to discuss important issues such as evidence quality, costs, and risks versus benefits.  Articles in newspapers and popular magazines generally lack the context to judge experimental results. They tend to overemphasize the certainty of any result, for instance presenting a new experimental medicine as the "discovery of the cure" of a disease, or an every-day substance as the "cause" of some dreaded disease. Newspapers and magazines frequently publish articles about scientific results before those results have been peer-reviewed or reproduced by other experimenters. Such articles may be based uncritically on a press release, which can be a biased source. They also tend neither to report adequately on the scientific methodology and the experimental error, nor to express risk in meaningful terms.


 * A news article should not be used as a sole source for a medical fact or figure. Editors are encouraged to seek out the scholarly research behind the news story. One possibility is to cite a higher-quality source along with a more-accessible popular source, for example with the "laysummary=" parameter of the Cite journal template.


 * On the other hand, the high-quality popular press sources can be very useful in describing the sociocultural aspects of medicine, disease, and health can be a good source for social, biographical, current-affairs and historical information in a medical article. For example, popular science magazines such as New Scientist and Scientific American are not peer reviewed but sometimes feature articles that explain medical subjects in plain English. As the quality of press coverage of medicine ranges from excellent to irresponsible, c C common sense and the general guidelines presented in the verifiability policy and general reliable sources guideline should be considered in determining whether a popular press source is suitable for these purposes.

- (end of proposal) Eubulides (talk) 17:30, 8 September 2008 (UTC)


 * The popular press is generally not a reliable source for science and medicine articles doesn't seem quite right. Perhaps The popular press is generally not a reliable source for science and medicine information might be more accurate.  An article that is primarily on a scientific or medical topic may include many facts that are not themselves scientific or medical in nature, such as the sales figures for a prescription drug.  WhatamIdoing (talk) 05:23, 9 September 2008 (UTC)
 * Let's combine these to say "information in articles". After all, a Ladybird book can be a reliable source of information, but certain not suitable as a source on WP. Colin°Talk 07:24, 9 September 2008 (UTC)
 * OK, I added the "information in", in the draft above. Eubulides (talk) 16:49, 9 September 2008 (UTC)

I've been following this discussion for a while, with a mixture of reactions. I agree with WhatamIdoing that "information" would be better than "articles" in the above, but I suspect that the more central issue is that: The popular press is not >as< reliable as is the original research articles. In some cases, the original research article is more accurate (my own scientific findings are very frequently misinterpreted by the press), but the original research article is oftentimes too technical for most WP editors to interpret themselves. — James Cantor (talk) (formerly, MarionTheLibrarian) 12:06, 9 September 2008 (UTC)


 * My own experience is that the original research is almost invariably more accurate, and all too often a lot more accurate, than the news stories about it. If that's the case, we should be citing the original research, instead of relying on the news story. A news story can be helpful for establishing the nontechnical context, but for the facts and figures themselves it's almost never a better source.
 * I agree that the original research article is often too technical for most WP editors. My experience, however, is that when that happens, the article is too technical for science reporters as well. One case in point is Abrahams & Geschwind 2008, arguably the best current review of the genetics of autism. This is a source that I suspect no professional news reporter can read and understand; at least, if there is such a reporter, I don't know who it would be. In autism, science reporters tend to go off and write stories on hypothesized environmental influences, in part because that's stuff they do understand.
 * Eubulides (talk) 16:49, 9 September 2008 (UTC)


 * No further comment on the reorganization (though there continues to be objection to some of the text being reorganized; this appears to be an independent issue), so I installed it. Eubulides (talk) 22:43, 16 September 2008 (UTC)
 * Sorry I failed to comment; I just saw the change, beautiful work. Sandy Georgia  (Talk) 23:07, 16 September 2008 (UTC)

What Schwitzer says

 * This proposed section misstates the source:


 * The popular press is generally not a reliable source for science and medicine articles. Most news articles fail to discuss important issues such as evidence quality, costs, and risks versus benefits. 


 * Schweitzer studied newspaper and TV news stories, not the popular press in general. His summary says nothing about popular science magazines, such as Scientific American, New Scientist, WebMD, etc.


 * I'm all for criticizing the press, but I also believe in objective research and having a solid scientific basis for your research.


 * I object to any statements about the popular press that simply reflects the personal opinions, prejudices or WP:OR of the editors.


 * There are lots of evaluations of the accuracy of popular scientific magazines. If you believe in peer review and the scientific method, you should read that literature and use that as the basis of your statements about the popular press.


 * For example, the standard reference book used by librarians to evaluate periodicals is Magazines for Libraries, which used to be edited by Bill Katz. The book has several chapters, at least one of which deals with scientific magazines, written by a librarian with a scientific degree, and I believe the chapter itself is peer-reviewed. (I have a copy filed away somewhere.) A statement about popular science books cited to Magazines for Libraries is reliable and meaningful. A statement based on the personal opinions of a WP editor (or even a majority of editors) is unreliable and meaningless.


 * Broad statements about the "popular press" or "popular scientific press" are also WP:WEASEL. How do you define "popular scientific press"? Is Scientific American or New Scientist the popular scientific press (and unreliable)? What about WebMD (which is reviewed by doctors)? What about IEEE Spectrum? Or the news sections of Science (which is often more reliable than the peer-reviewed articles they report on)?


 * Terms like "generally" are WP:WEASEL. They're using vagueness as a substitute for evidence. ("Let's compromise and say 'generally'.") Schwitzer doesn't say "generally," he says (based on research) that a majority didn't meet his predefined standards. Nbauman (talk) 15:36, 9 September 2008 (UTC)


 * The citation supports a claim about "news articles", not "popular press".
 * The proposed text clearly states that it includes Scientific American and New Scientist among the popular press.
 * As Colin wrote, this is a guideline not an article, and it doesn't need to cite sources to support its advice. If this sort of citation-quibbling is going to be a problem, I propose that we simply remove the citation to Schwitzer 2008. The text doesn't need that citation to reflect the working consensus of Wikipedia editors in this area.
 * Eubulides (talk) 16:49, 9 September 2008 (UTC)


 * Consensus includes me. Consensus is not a majority vote. Nbauman (talk) 17:05, 9 September 2008 (UTC)


 * Yes, of course, just as consensus is not necessarily unanimity. All this should go without saying. However, as far as I can see, the proposed change doesn't significantly add, remove, or change the advice, other than by reorganizing its text. The arguments in this subsection seem to reflect a longstanding disagreement with the advice, and that disagreement should be independent of this proposed reorganization. Eubulides (talk) 18:33, 9 September 2008 (UTC)
 * Consensus means "general agreement". If your opinion is in absolute conflict with the "general agreement", then the consensus does not include you. Furthermore, repeated attempts to assert that opinion, in spite of arguments by many other editors, is verging on tendentious behaviour. It is all very admirable, standing up for your profession, but I just can't imagine the folk at Britannica are having this sort of discussion. This is an encyclopaedia. If it isn't written directly by scholars (and we have a few), then at least it can be sourced to the work of scholars. Colin°Talk 20:03, 9 September 2008 (UTC)

Rfc Promotion of MEDRS to guideline
I would like to ask the community opinion regarding the promotion of this page to guideline status. This was done by DavidRuben over the objections of a significant minority of editors. Wikipedia_talk:Reliable_sources_(medicine-related_articles).

I content that this decision was unprecedented, extraordinary and contrary to the Wikipedia spirit and policies on consensus. I believe that the concerns of the dissenting editors were not adequately addressed. David's decision put a de facto stamp of approval on the majority's opinion, prevented us from reaching a mutually satisfactory accommodation and from further improving the quality of this page.

DavidRuben commented that: "admins weigh up proposals on the strength of the points raised, and frankly 2 of the opposing views were I thought weak and well argued against" "So just as AfD or AN/I (by admins) or RfA (by sysops) and other straw polls are decided finally by one person who weighs up the issues, but are not beholden to precise vote percentages, so I acted in this example." "Guidence can and should always be improved upon and that is what is currently happening in the talk page threads" User_talk:Davidruben

Paul Gene (talk) 11:39, 11 September 2008 (UTC)


 * Oppose guideline status. This guideline violates the pillars of Wikipedia in many ways. Changes were made without consensus. Changes were made without proposing them in talk. DavidRuben asserts that the opposing views were "weak and well argued against", so he unilaterally made changes; that is the very opposite of consensus. We should revert to the last consensus version and start over. Nbauman (talk) 12:11, 11 September 2008 (UTC)
 * Not so; in fact, this page has been developed and discussed over several years, and enjoys broad consensus. Also, can anyone pont to any guideline page that has been subjected to such a process as this?  They are guidelines; most Projects slap a tag on them and add them to MoS with far less discussion and consensus than this page enjoyed. Sandy Georgia  (Talk) 12:17, 11 September 2008 (UTC)

The two main objections to this guideline regard a preference for secondary sources over primary and discouraging editors from using the popular press (newspapers, magazines, TV) as a source of medical facts. The first point has been queried by two editors, of which Paul is the most vocal. The latter has been mostly queried by Nbauman, a journalist. These objections can be dismissed as in order to accomodate them, WP:MEDRS would have to be in conflict with both policy and long-standing guidelines that have wide consensus. Pleas to "revert to the last consensus version" are ridiculous since the only version that ever suggested newspapers might be OK at times, was one edited unilaterally and against consensus by Nbauman.
 * Both points have been part of these guidelines since since October 2006 when some text was adopted from WP:RS.
 * The warning "popular newspaper and magazine sources are generally not reliable sources for science and medicine articles" had been in WP:RS since April 2006 and remained until the page was rewritten/gutted in December 2006 when the text was moved to Reliable source examples, an essay. Newspapers remain at the very bottom of the quality pile at the policy page WP:V: "In general, the most reliable sources are peer-reviewed journals and books published in university presses; usually followed by university-level textbooks; then by magazines, journals, and books published by respected publishing houses; then by mainstream newspapers."
 * The guidance "In general, Wikipedia articles should not depend on primary sources but rather on reliable secondary sources who have made careful use of the primary-source material." is similarly to be found in WP:RS from April 2006. It can also be found today in policy: WP:NOR says "Wikipedia articles should rely on reliable, published secondary sources."

It should not be underestimated how damaging it would be if WP promoted the use of primary sources (primary research papers) or newspapers as a source for medical facts. The very worst of our POV pushers use such sources routinely because one can prove almost anything by carefully cherry picking basic research papers, or the uninformed scribblings that make up much press coverage of medical stories. Those editors with the educational and professional background that enables them to identify which newspaper articles are actually OK, or which primary research papers are worth citing, don't need WP:MEDRS to tell them how to write. And there's damn few of them. Colin°Talk 13:13, 11 September 2008 (UTC)


 * I oppose guideline status but can probably be ignored as an outlier because I fundamentally don't get how most points are specific to medicine (rather than scientific standards say, or existing core policies), or how it's in line with NPOV to subject a certain subset of pages to different basic standards/rewordings of core policies, and e.g. to say that if an article relates to medicine than medical sources are the "ideal sources" when infact sources and views from other fields are just as ideal according to the core policies. I guess this may relate to Paul Gene and others points about rewording core policies regarding primary/secondary sources. I didn't really want to get into this here but I thought I should just mention my take. EverSince (talk) 15:09, 11 September 2008 (UTC)


 * I don't see that the guideline was promoted inappropriately. Consensus on Wikipedia is not unanimous support.  There was broad support indicated in the discussion for promotion. This seems to be the general consensus of some of our best editors in the medical articles section of Wikipedia and I support their efforts to improve standards here.  The guidelines should be useful to all editors - I certainly gained greater insight into what I shouldn't be doing by reading them.  -- SiobhanHansa 20:35, 11 September 2008 (UTC)


 * A few observations:
 * Polling is not a substitute for discussion guideline states "Wikipedia is not a democracy; policy and guidelines are not ratified through a vote", and WhatamIdoing observed at Wikipedia talk:Reliable sources that " I could have just declared it a guideline -- but it's traditional at WPMED to make the extra effort to get community feedback in cases like this". So straw polling "Rfc Promotion" was not a requirement or essential, but helped foster a discussion that lasted 3 weeks about a proposal that had been 22 months in the drafting (10 November 2006 to 2 September 2008). By comparison WP:RS itself underwent 2.5 months of drafting and look how much that has changed since.
 * Policies and guidelines policy notes re Wikiproject recommendations that "some are eventually considered guidelines after sufficient consensus has been reached", and "sufficient consensus" indicates that consensus is not necessarily a 100% agreement as SiobhanHansa correctly observes, but a value judgement on the level of consensus.
 * To EverSince points, thank you - yes this is an "outlier" as it attempts to give further help on the main WP:RS (much as WP:MOS has several outlier sub-pages). As such there should be no implication of over-riding or rewriting WP:RS, just an attempt to help illustrate with examples (as guidelines do) and the "Assess the quality of evidence available" is a fairly international standard for biomedical journals and so useful to explain (it forms basis of generally prefering in the real-world review articles as secondary sources to single good quality studies, to observational studies, to annecdotal reports - but common sense and exceptions of course apply).
 * As for the "contenious" bit on role of newspapers, that anyone is arguing this aspect indicates that at the very least the value of such sources is not necessarily straight forward and editorial judgement is required - for as the guideline header tag indicates: "should be treated with common sense and the occasional exception". Finally I fondly recall an article in The Times that criticised the confusion of the terms 'virus' and 'bacteria' in the popular media as giving false expectations for patients that antibitics could cure the common cold or sore throat, only to conclude  that antibiotics were only of use for viral infections ! (go see "Common cold bacteria may cause blindness" which I wont treat as a reliable source, and Queen's Univerisity choice of press release title "Queen's researcher links common cold bacteria with cardiovascular disease" is misleading, although the report itself is well worded). David Ruben Talk 01:58, 12 September 2008 (UTC)
 * I should clarify that I meant my objection could be considered an outlier (partly 'cos I kind of tried to object to MEDMOS too, for similar reasons, though I ended up just confusing myself at the time). EverSince (talk) 02:59, 12 September 2008 (UTC)
 * I can also give examples of lies written in journals. For example, compare these two articles: ; the author of the former has a political agenda. Another problem is its emphasis on scientific articles. Only doctors have access to lists of patients, therefore only doctors can do scientific studies. What about misdiagnosis? People who are forced to be subjects of drug trials against their will? Malpractice? Doctors will not write about these topics for obvious reasons. So this guideline can be used to silence anyone who would write about these topics. Only a few editors have supported this proposal and most of them are in the field. It's as if employees of tabacco companies voted that only tabacco companies publications are allowed on tabacco articles. --Mihai cartoaje (talk) 04:03, 14 September 2008 (UTC)


 * Please quit wasting my time. Paul, you were on the losing end of the consensus.  It happens.  We've each individually been on the losing end of a consensus before (and probably will be again).  Don't you have anything more important to do than to drag this conversation out for yet another week?  Aren't there thousands of articles you could be writing now?  This consensus is not going to change just because you're still unhappy that this guideline gives examples and explanations of how WP:PRIMARY applies to medicine-related articles.  Alternatively, if you can't do anything else while this guideline conforms with a policy that you dislike, then please go over to [WT:NOR and talk them out of WP:PRIMARY.  This guideline will not contradict Wikipedia policy, even if two editors disagree with certain aspects of the policy. WhatamIdoing (talk) 03:16, 12 September 2008 (UTC)


 * Dear fellow editors! I am not trying to waste your time. This is not a discussion about primary and secondary sources. This is not the rehash of the vote which happened a month ago. This is a discussion about whether administrators can promote essays to guidelines at their discretion when the consensus has not been reached. I specifically asked the opinion of the wider community, as other people may have a wider knowledge of such precedents. Unfortunately Rfc bot malfunctions. It assigned the wrong date to the discussion. It also developed a personality and instead of giving it the summary I gave it "MEDRS was promoted to guideline over the objections of a significant minority of editors." it gave the discussion the following inane summary: " The reliable sources page for medicine-related articles at WP:MEDRS is widely used and widely referenced on talk pages. WikiProject Medicine solicits comments on the page before assigning it guideline status . (11:39, 11 September October 2008 (UTC))" No wonder the opinion of the wider community has not been forthcoming. I am trying to contact the RFC bot owner. Paul Gene (talk) 11:16, 12 September 2008 (UTC)
 * Paul, you don't seriously think that a human reading that page is going to say, "Oops, that RFC is dated for a month from now, so I should ignore it," do you? The date listed is the date that the RFC is going to be removed, not the date that it was opened.  WhatamIdoing (talk) 18:48, 12 September 2008 (UTC)
 * A consensus was reached. A consensus that a consensus was reached has been reached. --Arcadian (talk) 12:20, 12 September 2008 (UTC)
 * Well put. BTW: Any editor can create or demote a guideline. Admins aren't special in that regard. Colin°Talk 12:44, 12 September 2008 (UTC)
 * Well put. A consensus has not been reached, I shall demote this essay. Paul Gene (talk) 10:01, 13 September 2008 (UTC)
 * The following comments by DavidRuben: "Ok I've acted as an admin and promoted from a proposed guideline to an actual guideline" [] and "That said, admins weigh up proposals on the strength of the points raised, and frankly 2 of the opposing views were I thought weak and well argued against..." [] seemed to suggest that only admins can do it. Sorry, it confused me. Paul Gene (talk) 10:58, 13 September 2008 (UTC)

I feel that I was double-crossed in this discussion. I discussed my changes in Talk before making them and tried to gain consensus. Other editors reverted my changes without discussing them first, and made their own controversial (and wrong) changes without discussing them in talk. I tried to do the right thing, and the collegial thing, and others took advantage of me for doing that. Nbauman (talk) 21:00, 12 September 2008 (UTC)


 * I can see the why Nbauman feels that way. I tried to approach this essay the same way I approach potential FAC articles. It is raw, contains a lot of nonsense and redundancies but can be worked on and made really useful. And all of a sudden, DavidRuben decided that he has consensus to promote this page to guideline, when it was not even nearly ready. That was unwise and rash decision. It promoted the feelings of bitterness and the division between editors who were on the "right" and "wrong" sides of the issues. It discouraged further discussions and improvement. How David should have handled it? I kinda imagine this now almost extinct on Wikipedia figure of a Wise Old Admin who would have said: "Children! Go back and work out your differences. Make this page better, and then we will talk again." :) Paul Gene (talk) 11:15, 13 September 2008 (UTC)
 * Your approach is utterly wrong and may explain your urgent desire to demote a useful guideline. Unlike FACs which have a great push of effort by relatively few editors and then ossify once promoted, a guideline is always a gradual evolutionary work in progress. The promotion from essay to guideline occurs when it is generally accepted to be in a good enough state to be useful. A few trolls, vandals and stubborn nit pickers (choose your own category) should not derail what has been agreed by a large number of not-inexperienced editors. Tell me, how will this guideline prevent you doing good work on WP? Do you really have to be so disruptive because it hasn't reached FAC levels of precision and quality prose? I expect your recent demotions to be swiftly reverted. Colin°Talk 11:27, 13 September 2008 (UTC)
 * Dear Colin. My approach could be wrong but please do not punish me for being open with harsh words like "disruptive", "trolls, vandals and stubborn nit pickers (choose your own category)". There could be good sides in "stubborn nitpicking", look for example at SandyGeorgia's work. And there is a general concern about proliferation of various guidelines reflected, for example, in this discussion.[] Maybe the time has come to be more judicious about promoting essays to guidelines? I certainly did not feel "urgent desire" to demote this assay which was promoted on September 1. I gave myself time to reflect, and asked DavidRuben about his reasons for doing that. On reflection, it appears to me to be an ill-considered move, which defied basic principles of Wikipedia and is harmful for that reason. I believe, there are also reasons why using this essay as guideline would do more harm than good. I will address them later after this particular dispute about this promotion has ended. Please remember these words from the banner on this page: "# Be polite # Assume good faith# No personal attacks". Paul Gene (talk) 12:24, 14 September 2008 (UTC)


 * I'm sorry that you feel bad about this, but let's make sure that we have the situation correctly summarized here:
 * You proposed changes on this talk page.
 * You valiantly attempted to convince people that your changes were positive/helpful/desirable, but were opposed at every turn.
 * You made (some of) your proposed changes anyway.
 * Other editors looked at the talk page, realized that there was not only no consensus to support your proposals, but actually firm opposition, and reverted your anti-consensus changes.
 * I'm not sure that your behavior here really exemplifies collegial effort. The process is not propose-attempt consensus-make changes.  It's propose-IF consensus, THEN change, ELSE stop.
 * I can understand why you might feel like your views were ignored or even disrespected. I cannot understand why you think that removing your anti-consensus changes is a violation of consensus.  WhatamIdoing (talk) 21:37, 12 September 2008 (UTC)
 * Point of fact: consensus is not reached because some editor (or even some group of editors) declares it is reached. that's an inappropriate and incorrect way to close a discussion.  consensus is reached when all editors' concerns are addressed and at least minimally satisfied. if you neglect or refuse to enter into a discussion with other editors on certain points, then any claims of 'consensus' you make are specious and groundless, and can only be viewed as an attempt to disrupt the consensus process.  clear enough? -- Ludwigs 2  21:44, 12 September 2008 (UTC)
 * Nope, I checked Consensus, and I find not one word about requiring unanimous agreement.... despite, I might add, your attempts last month to redefine it as "all parties concerned with a particular article agree to the result of an edit or series of edits, or to the content of the article as a whole." I think you can safely assume that the firm opposition you encountered there is shared by a significant majority of editors here.  WhatamIdoing (talk) 21:55, 12 September 2008 (UTC)
 * lol - and you find 'not one word' of it there, because you yourself have been adamant in removing it when I put it in. I get it now - this is an issue of page-ownership for you.  you don't want consensus to actually be what most people would consider consensus, because that would limit your ability to unilaterally discard edits that disagree with your perspective.  geez, you're a card, aintcha...  -- Ludwigs 2  23:37, 12 September 2008 (UTC)
 * Actually, if you could be bothered to check your facts, I believe you will find that I've never edited WP:Consensus. WhatamIdoing (talk) 00:17, 13 September 2008 (UTC)
 * maybe not, but you sure have been arguing with me there. no matter, I opened up an RfC on it.  let's see what the community says.  -- Ludwigs 2  00:26, 13 September 2008 (UTC)


 * The following parts of the WP:CONS policy were ignored when this essay was promoted to the guideline. Thus I have taken a decision to demote it.


 * "In the case of policies and guidelines, Wikipedia expects a higher standard of participation and consensus than on other pages." (bold is mine. PG)
 * "Developing consensus requires special attention to neutrality - remaining neutral in our actions in an effort to reach a compromise that everyone can agree on." (bold is mine. PG)
 * "Minority opinions typically reflect genuine concerns, and their (strict) logic may outweigh the "logic" (point of view) of the majority. New users who are not yet familiar with consensus should realize that polls (if held) are often more likely to be the start of a discussion rather than the end of one. (bold is mine. PG)

Paul Gene (talk) 11:37, 13 September 2008 (UTC)
 * Paul, rather than wikilawering and citing irrelevant policy (WP:NPOV does not apply to guidelines pages, for example), please move on and accept that your points do not have wide approval. You disagreed with this guideline on the sole reason that you disliked the preference for secondary sources. This preference is enshrined in guideline and policy elsewhere on WP (see above). Unless you have another strong reason to object to this guideline, further argument is likely to get you nowhere. People coming to this RFC will want to know why you are kicking up a fuss. If it is merely that you think procedure wasn't followed, it will be met with a huge shrug. Colin°Talk 12:48, 13 September 2008 (UTC)


 * It's clear that we have overall consensus here, but not unanimity. This is enough for a guideline. For every guideline, some editors disagree with parts of that guideline. That does not mean every guideline should be demoted. I have therefore reverted Paul Gene's demotion, as not being a consensus change. Further discussion, along the lines that Paul Gene suggests, can occur here, independently of whether the page is a guideline. Also please see Wikipedia talk:Consensus for an ongoing discussion that I expect was sparked by this thread. Eubulides (talk) 15:16, 13 September 2008 (UTC)
 * by contrast, there's no sense making a guideline that large numbers of editors will ignore as unsound. -- Ludwigs 2  21:41, 13 September 2008 (UTC)


 * Colin, it is bizarre to call WP:consensus policy irrelevant to this discussion. Unlike WP:NPOV it clearly applies to the whole body of Wikipedia (see above quotations). My "wikilawering" was made necessary by the assertions of Eubulides and WhatamIdoing (who invoked the WP:CONS policy) that consensus does not have to include everyone. To answer Eubulides. He, Colin, DavidRuben and others believe that the majority can ignore the opinions of several editors. They call that "consensus". While they have the majority here, their definition defies common understanding of consensus, and the understanding of consensus by the wider community as described in WP:CONS policy. WP:CONS specifically addresses such cases: "Consensus among a limited group of editors, at one place and time, cannot override community consensus on a wider scale." Paul Gene (talk) 11:42, 14 September 2008 (UTC)


 * I support this page as a guideline, even though I'm sorry the move was made, as it bought a problem for free. There is nothing significant in this guideline that isn't supported by WP:V policy, except some medical terms definitions and concepts that clarify things relative to medical articles.  The page is a helpful guide for medical aricles, but significant editing practices won't change whether this page is a guideline or not, because the page correctly reflects WP:V policy.  I suggest that editors arguing against policy might do that at WP:V.  Sandy Georgia  (Talk) 22:03, 13 September 2008 (UTC)
 * The way how the move was made is unfortunate. As thousands of successful examples of work on the featured articles candidates show, the consensus can be reached within few days if the editors are willing. This essay actually draws more on WP:NOR that WP:V, so editors are encouraged to participate in the discussions at WP:NOR as well. The editors who argue with the common definition of consensus are also welcome to take part in WP:CONS discussions. Paul Gene (talk) 12:58, 14 September 2008 (UTC)


 * This page (WP:MEDRS) is OK as an essay but would be bad as a guideline. It is excessively prescriptive and does not mention editorial discretion even once. The whole problem of primary vs secondary sources is confusing. While the distinction is clear for historical sciences, for natural sciences (such as medicine) it is very hard to pinpoint. If you read the above discussions you will see that primary source may contain pieces of secondary sources, secondary sources contain pieces of primary sources, press-releases are in the grey zone, and even journalism which in historical sciences solidly placed into primary sources may more often be considered secondary source for science.


 * To spare editors this confusion, we should delete primary-secondary definition and all the related discussion and leave it up to the WP:RS to argue. Instead, we would leave the distinction between sources based on their origin: peer-reviewed (reviews and research papers), books, journalism (popular press and popular science press), press-releases and other forms of communication. It would be rather the way WP:V does it. This will make WP:MEDRS shorter and more readable. Editorial discretion should be emphasized.


 * This will require a massive re-write and editing out large portions of the text, which the guideline status would interfere with. This will require a fresh start and flexibility on the part of editors who often argued here that something is good because it had been in this essay for years and reverted based on this argument. This will require a lot of good faith. Do we have it? Paul Gene (talk) 13:18, 14 September 2008 (UTC)


 * Paul, there is no reason that the content of this guideline can't be discussed and even radically changed while remaining a guideline. It happens on MoS quite regularly and happened to WP:RS a while back. If you want to work (with others) on an utterly revised version, it can be done on a sub-page and presented as an alternative for approval/discussion. Or done section by section.
 * The "consensus" dispute is a sideshow. Just troublemaking.
 * I really don't understand this desire to insert "use editor discretion" into individual guidelines. Editors have common sense (most of them), know the difference between guideline and policy, and we have WP:IAR. I find it patronising. It would be like the highway code telling me to drive on the left, except if there's a huge hole, a parked vehicle, a fallen tree, or a cow in the way.
 * The primary vs secondary issue is vital. Some editors find it confusing, some editors claim it is confusing (an entirely different thing!) and other editors hit the keyboard before engaging their brain. We must cover it and it really isn't that hard to pinpoint. Yes, individual works can contain a mixture of source types. So what. The historical sciences regard journalism as (mostly) a primary source because in the coverage of current affairs, the journalists are eyewitnesses. In the coverage of science and medicine, this is rarely the case. In those cases, the journalist is basing his writing on the writing of other (primary or secondary) sources. Is that so hard?
 * It is vital that we don't encourage editors to "perform their own review of the (primary) literature" as someone wrote earlier, as this makes it all too easy for the POV pushers or even well-meaning editors to mislead the reader.
 * I'm most disappointed that you are edit warring over the tag on this guideline. Removing the tag once was your BOLD statement. The second revert was just being disruptive. If your opinion is held by a significant number of other editors, couldn't you wait for one of them to act? Try WP:1RR? Colin°Talk 14:53, 14 September 2008 (UTC)


 * Oppose There is no consensus here, yet. Consensus is when there is unanimity in the sense that everyone involved finds the proposal acceptable (although some may still prefer another proposal).  Stopping short of that is majority rule or fiat.  I feel that this proposal is contrary to the intent if Wikipedia, in that it tries to prescribe what is fundamentally a matter of editorial judgment.  If there is a content dispute, the dispute should be discussed and resolved via the dispute resolution process.  This proposed guideline attempts to make rules to prevent disputes, and while the intention is good I think such rules are counterproductive.  --Una Smith (talk) 14:54, 15 September 2008 (UTC)
 * Please read WP:CONSENSUS: it has nothing to do with "unanimity". Sandy Georgia  (Talk) 14:57, 15 September 2008 (UTC)
 * I have read it, and objected to it. It reflects the same misunderstanding about consensus that is echoed by some editors here. Someone here (I'm not sure who, signatures are lacking) wrote "The process is not propose-attempt consensus-make changes. It's propose-IF consensus, THEN change, ELSE stop." That editor is correct except instead of "stop", it should be "repeat".  Many editors on Wikipedia seem to think a consensus process is "propose-attempt consensus-make changes", but they are mistaken.  On Wikipedia, some good examples of a consensus process that works as it should can be found in formal mediation.  There are two possible solutions to WP:CONSENSUS that I can accept:  change the content, or change the title.  We can choose merely to attempt consensus, but in that case we should not pretend that we are achieving consensus. --Una Smith (talk) 15:49, 15 September 2008 (UTC)
 * So, we have editors opposing the content of this guideline because it repeats aspects of policy they disagree with, and opposing the promotion of this guideline because the procedure followed aspects of policy they disagree with. If folk have problems with policy, discuss that on the policy page and accept that until those policy pages change, the rest of us should be given some slack in following them as best we can. Colin°Talk 17:48, 15 September 2008 (UTC)


 * Agree. If Wikipedia ever adopted a definition of consensus that required everybody to find the proposal acceptable then we may as well pack up and go home. Una, can you give an example where the guidelines would be "counterproductive". Colin°Talk 15:10, 15 September 2008 (UTC)
 * The proposed guideline would be counterproductive by expanding content disputes into secondary disputes about the validity of the guidelines. Two disputes instead of one is not helpful. --Una Smith (talk) 15:49, 15 September 2008 (UTC)
 * But that is an argument against all guidelines whatsoever. Surely you don't favor repealing all guidelines? Assuming you don't, can you give a more-specific example where the guidelines in WP:MEDRS would be counterproductive? Eubulides (talk) 16:29, 15 September 2008 (UTC)
 * It is not an argument against all guidelines. It is an argument against guidelines that would use rules to shortcut the consensus process that is fundamental to Wikipedia.  It tries to answer the question "which is the better evidence in this case?" by substituting for it (and answering) the question "which is the better class of evidence?"  I have seen that substitution tried before, but I have not seen it work.  --Una Smith (talk) 19:34, 15 September 2008 (UTC)


 * Comment Since there's a couple of you who misunderstand WP:CONSENSUS, you are attempting to use to delete this guideline. Consensus is not unanimity.  And it is not a loophole for one or two editors to block progress.  Nevertheless, I'd like to know what we're trying to find consensus on?  The group is in agreement that it's a guideline.  Absent a good argument why it shouldn't be (and wikilawyering won't convince me, but what is specifically wrong with the guideline will), can we end this conversation.   Orange Marlin  Talk• Contributions 16:39, 15 September 2008 (UTC)
 * I agree that an editor has declared it a guideline, and that some other editors claim the declaration reflects a consensus, and that there is a consensus in the sense that consensus is defined in WP:CONSENSUS.  Where we don't agree is re whether the definition in WP:CONSENSUS is acceptable.  That question is the subject of another ongoing RfC, by the way. --Una Smith (talk) 19:34, 15 September 2008 (UTC)
 * Colin above suggested that, if you strongly oppose this page being a guideline, you should remove the tag. If I am the only one doing it, the majority will continue to claim that the consensus exists and to ignore you with impunity. Paul Gene (talk) 01:59, 17 September 2008 (UTC)
 * I can't find where I suggested that and can't imagine why I would do so. I said "Any editor can create or demote a guideline". You could go and take the policy tag off WP:V but it would be very unwise to do so. It was not my intention to suggest or encourage any such action. Removing the tag is not the only way to make one's views heard, or to publicise a dispute. Colin°Talk 08:47, 17 September 2008 (UTC)

'''Majority wants a war. Should the minority go along and give it to them?''' Colin, despite multiple "oppose" you incredibly claim that any kind of consensus exists. Your logics goes like this: "one editor is an outlier, another one should be dismissed for the extravagant views, third is a wikilawer, fourth - he is alone, we can ignore him. Hooray, we have a consensus because nobody reverts us!" You actually invite an edit war by writing to me: "Removing the tag once was your BOLD statement. The second revert was just being disruptive. If your opinion is held by a significant number of other editors, couldn't you wait for one of them to act?" Paul Gene (talk) 11:57, 17 September 2008 (UTC)
 * Paul, which discussion are you referring to? (1) the one that was held before David promoted the guideline or (2) this one on whether the promotion was valid. In (1) there were 18 participants and 15 support. One oppose was, it turns out, concerned with the idea that medically trained doctors might not be a reliable source for medical articles. I think we can all safely ignore that one. The other two (you and Una) objected to the preferential regard given to secondary sources. I really don't know what more can be said about that other than go and change the policy pages first, then come back here. In fact the same advice applies to the second discussion about consensus.
 * As for your interpretation of my words you quote: how is asking you not to continue making unilateral reverts an "invitation to edit war"? I'm seriously considering unwatching this page because discussing this further is not a productive use of my time. Colin°Talk 15:36, 17 September 2008 (UTC)
 * Having gone back and had another look at that original oppose by Mihai cartoaje (I missed the original vote) I have to totally disagree with that characterization of what that editor was trying to say, and with how it was undermined at the time. It partly seems to have been rejected on an ad hominem basis. I can see why but I believe good faith should be assumed regarding any editor (and having indirectly encountered that editor before on another article, I believe they have well-intentioned and totally understandable views relating to stigmatization of those diagnosed with mental disorders for example). My understanding of what the editor actually said, for example "WP:RS requires third-party sources. I don't think Project Medicine editors can overrule Wikipedia policies. Anyone can start a wikiproject" and "Third-party, not tertiary. It means non-partisan" - is that it very much relates to my concern, which is that although in some cases the concept of a "medical article" is straightforward, in many areas "medicine" and medical sources may represent one POV, not necessarily a neutral subject matter or the only or best source of "facts" and views. And as such, these guidelines could inadvertently allow editors to undermine the NPOV pillar of Wikipedia. The very extent to which the issues are "medical" may be disputed within the literature - perhaps even within the medical literature but especially outside it - but this and MEDMOS can legitimize structuring articles in the manner of medical textbooks. Especially when other POVs (fields/professions/academic areas etc) don't have their own tailored sourcing or style guidlines. This is completely separate from whether these documents contain valuable and useful information to help those wanting to source from within the medical field and from a medical POV, which they clearly do. EverSince (talk) 16:22, 17 September 2008 (UTC)
 * See WP:FRINGE; if you have an example of what you reference that is not a fringe theory, according to all sources, please bring it forward. Every example I've seen of what you refer to is a fringe theory even when accounting for broad sources, and I most certainly keep an eye out for medicalization of "disorders".  Sandy Georgia  (Talk) 16:29, 17 September 2008 (UTC)
 * I haven't mentioned any theories... The existence of clinical and academic fields and professions other than medicine, which sometimes overlap on the same subjects, is surely not in dispute? EverSince (talk) 17:59, 17 September 2008 (UTC)
 * I regret that "ad hominem" remarks were made (though I attempted to AGF in my response). It was only the later remarks by Mihai where it became clearer that he (a) didn't trust doctors (b) thinks only doctors can publish in scientific journals regarding medicine. I have no answer to the former but the latter just isn't true.
 * There's certainly overlap in articles that might require drawing on elements of history, politics, popular culture, etc. This guideline is concerned only with the medical aspects and in some areas it is fuzzy as to whether something is medical at all. Perhaps the text could be modified to make it clearer that not all the text in a so-called medical article is necessarily covered by these guidelines. Really, these sort of tweaks are the kind of thing I was hoping would result from the extra eyes seeing a formal guideline. It really doesn't help if the are presented as some kind of adversarial dispute that must be resolved prior to any progress being made. Colin°Talk 18:30, 17 September 2008 (UTC)
 * I think it should include some caveats and clarifications along those lines, encompassing also the issue of non-medical sciences that may be involved in given articles; Scientific standards seems to cover these issues and concerns a bit more (and to overlap with this guideline quite a lot, needs coordination?). Btw I was just checking Policies and guidelines, 'cos I realised I'm unclear by what criteria something is considered a guideline vs a help page, and I noticed it also says: "A proposal's status is not determined by counting votes. Polling is not a substitute for discussion, nor is a poll's numerical outcome tantamount to consensus." EverSince (talk) 17:55, 18 September 2008 (UTC)


 * Not seeing the consensus for guideline status. I have reverted accordingly.  Colonel Warden (talk) 19:15, 20 September 2008 (UTC)

Edit-warring over guideline status
Without further discussion Ludwigs2 removed the guideline tag with the comment "when and where was there consensus for this?", and when I reverted, pointing out for the consensus and this thread for further discussion, Ludwigs2 removed the tag again, with the comment "are you guys trying to edit war this in?". This sort of editwarring and inflammatory language (also present in the paragraph that started this subthread) is counterproductive. Eubulides (talk) 21:38, 17 September 2008 (UTC)


 * And then he reverted again, and then Paul did. This is beyond tiresome, guys.  The consensus is that this is and should be a guideline; if you want that to change, then you need to change the consensus right here, on this talk page, FIRST.  WhatamIdoing (talk) 00:31, 18 September 2008 (UTC)

Brandon Hill lists
This edit inserted two copies of recommendations for Brandon Hill Selected Lists. But Brandon Hill is no longer being maintained; the last version was issued in 2003. I prefer that the book list not be mentioned: many of the books on that list are obsolescent or even obsolete. The list of journals isn't so bad as it doesn't go stale so fast, but even there it's a bit iffy, and if it is mentioned we should caution in the main text that the list isn't being maintained. Eubulides (talk) 00:12, 14 September 2008 (UTC)


 * To be more precise, I propose removing the following text from WP:MEDRS:


 * Print Books and Journals for the Small Medical Library 2003 (Brandon Hill Selected Lists) lists 141 journals as a selection guide for health sciences library. Although the guide will no longer be updated, many of the journals listed have been included for many years in past guides.


 * and the following text from WP:MEDRS :


 * Print Books and Journals for the Small Medical Library 2003 (Brandon Hill Selected Lists) lists 672 books as a selection guide for health sciences library. Although the guide will no longer be updated, many of the books listed are updated frequently and a new edition may be available.


 * Eubulides (talk) 21:38, 14 September 2008 (UTC)


 * I support this proposal for the reasons given above. &mdash; Mattisse  (Talk) 21:52, 14 September 2008 (UTC)


 * Is the list useful or not? Has anyone used it to choose which source to use, when PubMed or some other search turns up a selection? Would anyone really restrict their choice of sources in an article to just one book because that was the only one in this list? I can't see it helping me choose sources in the epilepsy-related articles. The goals of that list do not align with ours. It seeks to provide a restricted list of books and journals to a budget that would be useful in a small hospital library. We are not librarians but editors, and we will find and use the best sources that we can access -- which may be more or may be less than this list allows. Colin°Talk 22:00, 14 September 2008 (UTC)
 * Myself, I would not use this list. I think the list exists primarily for people that need to find the "single best" source AND that don't know much, if anything, about the subject itself.  By contrast, I'll use any reasonably current normal college or med school textbook that comes to hand, and not mind so much whether there's a slightly better textbook elsewhere. WhatamIdoing (talk) 05:12, 15 September 2008 (UTC)


 * Keep It is stated in the added text that the 2003 guide is no longer updated (reference included). The list is intended as a core collection ($144K); for libraries with a budget the list is marked with a * ($64K) or dagger ($18K). . "Journal title selections remain relatively stable." PubMed lists only journal articles which include primary and secondary sources. Books are secondary sources and are not listed in PubMed. The book list does include  many of the standard textbooks used in medical school and by practicing physicians.  The best books have been published for several editions; so a quick internet search for the newest edition should be easy. amazon.com also includes customer reviews e. g. Harrison's Principles of Internal Medicine There are usually more than one book listed for the different subject areas, so there is not a "single best" source, but several. Different medical schools use different textbooks for their classes, but many use the ones marked with a *.  I added this list as a starting point for readers to see what books and journals are valuable. As a practicing physician and former assistant clinical professor, I've used this list for several years whenever I order a book for our clinic library.  This list is only for those references in print; many now have on-line versions as well. I also use UpToDate which is only online and not included in the Brand/Hill print list. Petersam (talk) 09:23, 15 September 2008 (UTC)


 * Keep. I found out about the Brandon-Hill list when a medical librarian recommended it to me. I used it to find the major textbooks in each discipline, like (looking at my bookshelf) Harrison's internal medicine, DeVita's Cancer, etc. Not only do I use it to find textbooks to read, but since each of the authors is a recognized authority in the field, I can search PubMed for their articles.


 * Furthermore, even though the last version was updated in 2003, the selection has been relatively constant for decades; most of the textbooks have been recognized standards for generations. Harrison's is 50 years old. The textbooks are updated regularly, so the latest edition is not obsolete.


 * The journal titles are even more constant. Some of the standbys are over 100 years old. I use the Brandon-Hill list for searching PubMed. A PubMed search on a common topic can return thousands of hits. By selecting the major journals in the field, as defined by the Brandon-Hill list, I'm more likely to get important articles and reviews.


 * That's why it's useful. It's much better than nothing, and we don't have anything to replace it. Do we?


 * Citation analysis, while useful, is not the same. Citation analysis has commonly-acknowledged biases, for example, towards techniques. Citation analysis is generated by a computer algorithm, while the Brandon-Hill list was selcted by a team of librarians, most of whom have medical credentials themselves.


 * So the Brandon-Hill list is useful. I think the above answers all your objections. What objections do you have left? Nbauman (talk) 17:16, 15 September 2008 (UTC)

(outdent) There doesn't seem to be consensus for removing all mention of Brandon/Hill, but still, the current mention is way overkill. What I sense in the support for Brandon/Hill is nostalgia for the old way of researching medical topics, where one went to the library and read books. That was valid 20 or even 10 years ago, but nowadays almost everybody coming into the field reads this stuff online, and the Brandon/Hill list is (how shall I say it?) quaint. For more on this subject, please see the following source, which (I can't resist saying this) is freely available online:

With that in mind, I propose removing the paragraphs in question and then appending the following bullet to WP:MEDRS


 * The Brandon/Hill selected list contains a list of books and journals suitable for a small medical library. Although the list is no longer maintained, its sources are high quality and many of the listed books are updated regularly.

This would of course come with a citation to the latest list. Eubulides (talk) 17:59, 15 September 2008 (UTC)


 * It's not nostalgia for the past, and the Brandon-Hill list is not quaint. Medical librarians, publishers and researchers have always eagerly embraced new technology, eg PubMed, and discarded obsolete technology, eg card catalogs.


 * The Brandon-Hill list was important because it captured the structure of how medical information is organized: There 'is' such a thing as core journals (141 of them, at one count) and textbooks (about 672 of them). People will be following that structure whether they're on paper or online.


 * The specific titles aren't all that important -- the important idea is that there is such a structure, and that a relatively small group of journals and books are accepted in the medical community as reliable.


 * I think the original wording is better than the proposed change. It's important to retain the idea of 141 journals and 672 textbooks, because it gives people a sense of the size and character of this body of knowledge. That's a manageable number of citations.


 * This is useful guidance for Wikipedia editors because editors are always doing Google or PubMed searches and coming up with obscure journals. It's important to explain to them that some journals are more important and reliable than others. It's one thing to see a study of an alternative medicine treatment in a small obscure publication that nobody ever heard of. It's another thing to see the same study in a major journal, like Urology.


 * I'll ask you: Do you have anything to replace the Brandon-Hill list, that explains the medical literature as well, and serves all of these purposes as well as the Brandon-Hill list does? Nbauman (talk) 19:39, 15 September 2008 (UTC)


 * Regardless of whether one considers a 5-year-old list "quaint", the latest proposal is not to delete mention of the list; it is to avoid covering that list too heavily. WP:MEDRS currently contains multiple instances of phrases like "core selection guide for health sciences library" and "although the guide will no longer be updated" and "high quality". There is no good reason for this duplication, particularly since most of the editors who've weighed in on this issue have expressed skepticism that Brandon/Hill should be mentioned at all. The only explicit objection you've given to the latest proposal is that it omits counts, so here's a new proposal for the bullet wording that fixes that problem, as well as mentioning the date of the list.
 * The Brandon/Hill selected list mentions 672 books and 141 journals suitable for a small medical library. Although this 2003 list is no longer maintained, its sources are high quality and many of the listed books are updated regularly.
 * Eubulides (talk) 21:05, 15 September 2008 (UTC)


 * Petersam has followed up by making further edits, without discussing them here. These further edits do not address the main problem, which is that the text contains significant duplication and overemphasizes a list that many editors would like to see dropped. It would be better to discuss these changes before installing them. The above proposal (of removing the duplicative discussion, and replacing it with the bullet proposed above) still stands. Eubulides (talk) 22:51, 15 September 2008 (UTC)


 * Sorry, just incorporating some of the previous ideas to see how they looked....I shall wait... It's not necessarily a duplication. The first section on medical journals has an intro paragraph, then goes into a subsection on core journals. The Brandon Hill list on journals is relatively stable and includes a small core list of 59 journals  because a library  "usually cannot afford or may not need all of or most of the listed (141) publications." The article currently lists only 6 core journals.  Rather than listing all the journals, having a reference to a list would be helpful.  Maybe that paragraph should go below into the Core journal subsection.  The section on medical textbooks does not have a subsection on core textbooks.  Brandon Hill lists 672 books with 251 suggested for first purchase and 104 listed as a minimal core book list. These core books are high quality and are updated regularly...e.g. Gray's Anatomy 38th ed., Stedman's medical dictionary 27th ed., Rosen's Emergency Medicine 5th ed., Family Medicine 6th ed., Harrison's 15th ed., Washington Manual 30th ed., etc.  So, the core list is also fairly stable; you just need to get the lastest edition. Instead of listing a bunch of the core textbooks, having a reference link is helpful. Again, this can be a leading to a new subsection on "Core Textbooks" similiar to the subsection on "Core Journals" listing only a few instead of many.   Brandon Hill has been a valuable reference for 38 years.  I'm sure some medical librarian somewhere will be continuing this resource.  When I find it, I shall list it as an update. Any other thoughts? Petersam (talk) 00:41, 16 September 2008 (UTC)


 * The phrases I mentioned (e.g., "core selection guide") are indeed duplications within WP:MEDRS. The previous comment does not otherwise seem to address the specific proposal made, namely to coalesce these duplications and list Brandon/Hill just once. If some medical librarian somewhere updates Brandon/Hill sometime, that'd be fine, but in the meantime the current list is obsolescent and should not be emphasized so much here. Eubulides (talk) 03:14, 16 September 2008 (UTC)


 * I believe that this guideline should educate WP editors in the way that medical publication works, in particular the way the literature is divided into core journals and textbooks in general medicine and the specialties. The Brandon-Hill list is important because it teaches this idea, not just because it lists specific journals or books.


 * I don't think it's as useful to give WP editors a list of particular books that we have decided are "reliable". We should teach them how to arrive at that conclusion themselves. Nbauman (talk) 02:07, 16 September 2008 (UTC)

Nbauman wrote: The specific titles aren't all that important -- the important idea is that there is such a structure, and that a relatively small group of journals and books are accepted in the medical community as reliable

I disagree with this assertion. The only reason to have this list at all is to provide guidance on selecting specific titles. Yes, there are journals that have very good reputations and journals that have very... weak reputations. But I think that pretty much everyone knows that. We don't need this list to "prove" that some journals are considered better than others. It's not a disputed fact. The only value that this list provides is the list of specific, "approved" titles.

And while I don't actually mind the list of journals, fundamentally my problem is with appearing to recommend one perfectly decent textbook/reference book over another equally decent book. The fact that Brandon Hill, for example, chose Wintrobe's Clinical Hematology (ISBN 0781736501) to Turgeon's Clinical Hematology (ISBN 0781750075) doesn't mean that Turgeon's isn't a perfectly decent book. In fact, I'd go so far as to say that either of these books are better than any research publication in any journal. Their choice to exclude Turgeon's fundamentally means "A small medical library only needs one book like this," not that Turgeon's (or several other similar texts) is unreliable. WhatamIdoing (talk) 02:28, 16 September 2008 (UTC)


 * If you look at the Brandon Hill list for Hematology; you will find 4 minimal core books including Williams Hematology (ISBN 0071435913), 7 initial purchase books, and 15 total books. Sure, Turgeon's may be a decent book, it's just not as comprehensive as the other two. Got Doody's rating by emailing a local medical reference librarian in Oakland; they are very helpful in helping anyone find information. The Doody Hematology book ratings were by Content Specialist Steven Rosen, MD , Northwestern University Feinberg School of Medicine, Robert H. Lurie Cancer Center, Chicago, IL plus 2 Librarian Selectors.

. Petersam (talk) 07:31, 17 September 2008 (UTC)


 * I did not claim that Turgeon's is as good as Wintrobe's: only that its exclusion from Brandon Hill doesn't make it fail WP:RS.  WhatamIdoing (talk) 21:07, 17 September 2008 (UTC)


 * Found a replacement for the Brandon Hill books with Doody's Core Titles. Seems to be consensus to keep Brandon Hill for journals. Petersam (talk) 08:01, 16 September 2008 (UTC)


 * There is no consensus to keep. Two editors are in favor (you and Nbauman), two opposed (myself and WhatamIdoing), and one skeptical (Colin). I see that edits are continuing to take place in the project page without discussion in advance, and without responses to my suggestions here.
 * Doody's Core Titles is not freely available. It is not a particularly good source for Wikipedia editors. It should not be emphasized on this page.
 * For now I trimmed down the mention of Brandon/Hill and Doody's, as the previous text was clearly excessive.
 * It is still not at all clear that Brandon/Hill and Doody's should be mentioned here. It would be more convincing if we knew that Wikipedia editors of medical articles were actually using Doody's and Brandon/Hill so extensively that they were worth citing here.
 * Eubulides (talk) 16:53, 16 September 2008 (UTC)
 * How about posting a query at WT:MED to see if anyone uses them. Colin°Talk 17:11, 16 September 2008 (UTC)
 * Thanks for the suggestion. I asked at WT:MED. Eubulides (talk) 18:11, 16 September 2008 (UTC)


 * I don't know why you're trying so hard to remove information that some of us think is useful. You raised the objection that the list is obsolete, and we answered it -- it's not obsolete. You've given no reason for removing it except WP:IDONTLIKEIT.


 * There is no consensus to keep, but there is no consensus to delete, and -- to use your own argument -- it's been in the guideline for about a year. Nbauman (talk) 18:36, 16 September 2008 (UTC)


 * (ec) I very strongly agree with User:Nbauman's comment above: I don't think it's as useful to give WP editors a list of particular books that we have decided are "reliable". We should teach them how to arrive at that conclusion themselves. Providing a list of preferred sources from 2003 does just the opposition. It gives the uninformed editor the impression that these sources are reliable sources for whatever article that editor is sourcing. &mdash; Mattisse  (Talk) 18:38, 16 September 2008 (UTC)


 * As we explained above, this is a 2003 collection of books and journals that have been recommended by authoritative sources for decades. Every title on that list is still a major journal or book today.
 * They are reliable sources. Can you cite one title on that list that is not reliable? Nbauman (talk) 19:57, 16 September 2008 (UTC)
 * They may be dated or lacking in information on certain subjects, for example the posthumorous diagnosis of Samuel Johnson with Tourette syndrome. It is not that a particular book is globally unreliable. Although a book that has not been updated since 2003 might contain outdated information. That is a long time ago in the world of scientific research. Are you saying that they are all regularly updated? &mdash; Mattisse (Talk) 20:26, 16 September 2008 (UTC)
 * Journals are not reliable sources. Journal articles are. Certainly one can cite unreliable articles taken from a Brandon/Hill-listed journal (one example: Wakefield et al. 1998, ). But this is straying from the point; please see below. Eubulides (talk) 20:30, 16 September 2008 (UTC)
 * Almost. Journal articles, properly used, are reliable sources for Wikipedia's purposes.  If you've ever watched RSN for any length of time, you know that reliability can't be determined in a vacuum.  A perfectly reliable source for fact X may be hopelessly unreliable for fact Y.  WhatamIdoing (talk) 04:11, 17 September 2008 (UTC)

Brandon/Hill and Doody's are not that useful for Wikipedia

 * Brandon/Hill omits high-quality journals like Cochrane Database Syst Rev that are too new to make the list. I just now checked all uses of cite journal in Wikipedia's featured medical articles. The #1 journal, with 50 citations, was N Engl J Med (not surprisingly). But #2 was Cochrane, with 48 citations, and Cochrane is too new to be on the Brandon/Hill list.
 * Be careful of your conclusions -- Cochrane was not in the Brandon/Hill Selected List of Print Books and Journals for the Small Medical Library because Brandon Hill only covers PRINT media, not electronic databases like the Cochrane (see bottom of page 2. Petersam (talk) 07:42, 17 September 2008 (UTC)
 * This underscores the obsolescence of Brandon/Hill. Its page-2 mention of "audiovisuals or microcomputer software" is a charming anachronism. Even in 2003 it was strange and old-fashioned to exclude discussion of online access, with regards to a medical library, as the vast majority of research medical journals were searched for and accessed online. Nowadays, of course, medicine is even more online than it was 5 years ago. Again, there's no indication here that Brandon/Hill is all that relevant to Wikipedia editors today. (And for what it's worth, you can order printed copies of individual Cochrane reviews from the publisher, though I expect hardly anybody does that.) Eubulides (talk) 08:19, 17 September 2008 (UTC)
 * Your excerpt was taken out of context and refers to media programs and media centers. The electronic and online resources are mentioned at the end of the paragraph. This list is, as the title implies, limited to print media -- books and journals. Health sciences librarians who need to purchase audiovisuals or microcomputer software but lack knowledge of such media should request assistance from other librarians who have initiated a successful media program or from an academic media centers. We have not perused the electronic books and journals available on the Web or CD-ROM, and we do not intend to do so at this time. Brandon and Hill's 38 years of expertise was in the print media and the 2 people knew their limitations. Doody's Core Titles (which includes many more people) has taken over Brandon/Hill functions and does include software as well as print titles some of which have online versions. http://www.doody.com/dct/ Doody's Review Service has a database of nearly 20,000 reviews and Bibliographic information on 90,000 book and software titles in 120 specialties. http://www.doody.com/drs/  Most medical libraries now have online access to all medical resources on the web... e.g. a major medical school http://library.ucsf.edu/  as well as a local hospital in Oakland http://www.samuelmerritt.edu/library  . Some of these online resources are restricted by licenses.  Brandon/Hill and Doody's are relevant to Wikipedia editors to help them identify the best print/software medical resources available; some of which also have online editions. Brandon/Hill is freely accessible and can be used as a first go through to identify possible quality print resources; especially those that have been published with several editions. (See example table above for Hematology textbooks.)  Editors can then contact (in person or via email) their local medical reference librarian who are more than happy to help them to access other recent resources and reviews (such as Doody's) if they are unable to access them on their own. You might need to go into the library to use it depending upon the licensing restrictions. Petersam (talk) 09:45, 18 September 2008 (UTC)

Eubulides (talk) 20:30, 16 September 2008 (UTC)
 * And this is not the only sign that Brandon/Hill is obsolescent. For example, J Infect Dis was a reasonable choice ten years ago for a journal on infectious disease, but these days Lancet Infect Dis publishes more high-impact papers in that area. And the list's coverage of psychiatry is antediluvian: it doesn't list any journal on the topics of autism or schizophrenia, for example. If Autism had been written by editors relying on Brandon/Hill, it would be a much, much weaker article.
 * Doody's does not suffer from Brandon/Hill's problem of obsolescence; but it is a proprietary source that Wikipedia editors by and large do not have access to.
 * These objectious would be overcome if there were evidence that the use of Brandon/Hill or Doody's was improving Wikipedia articles. So far we haven't seen any evidence of that. My own impression is that mentioning Brandon/Hill and Doody's here is not helpful enough to justify their inclusion.
 * Could you put the list you generated into a public space? Also, I've created a stub for Brandon-Hill list, and a stub for Doody's would also probably be a good idea. --Arcadian (talk) 21:36, 16 September 2008 (UTC)
 * I put the list this version of my sandbox. Eubulides (talk) 22:05, 16 September 2008 (UTC)

Press review websites
The text currently says


 * Sources for evaluating health-care media coverage include review websites such as Health News Review and specialized academic journals such as the Journal of Health Communication; reviews can also appear in the American Journal of Public Health, the Columbia Journalism Review, The Guardian, and others.

I think it would be more useful to editors if the Health News Review was a direct link to the web site. I would like to add the UK's Behind the Headlines which does a good job of staying on top of the latest headlines and links to the scientific papers. In addition, Ben Goldacre's column in The Guardian would be more usefully linked as Bad Science since otherwise an unfamiliar reader wouldn't know where to look in that paper's huge archive. Colin°Talk 20:19, 16 September 2008 (UTC)


 * These suggestions all sound good to me. I assume the wikilink to Health News Review would be kept? It's also useful. Eubulides (talk) 20:30, 16 September 2008 (UTC)
 * If you can find a way to keep the wikilink, OK. Look at WP:MOS's "Other resources" section. It doesn't bother with footnotes and just embeds the hyperlinks. Colin°Talk 21:49, 16 September 2008 (UTC)
 * OK, I gave it a shot with this edit. This also mentions Media Doctor, a pioneer in this field. Eubulides (talk) 22:27, 16 September 2008 (UTC)

Village Pump (policy)
I have requested further participation from folk by posting a message at Village pump (policy).

The aspects in dispute appear to me to be


 * The promotion of secondary sources over primary (for example, academic review papers rather than primary research papers).
 * Discouraging the use of the popular press (newspapers) for medical facts.
 * That the guideline was promoted without unanimous agreement.

Those disputing are IMO in conflict with policy pages and should take their argument there first. Is this an accurate description of the dispute or do people have other issues with the guideline or its promotion. Colin°Talk 21:58, 17 September 2008 (UTC)


 * This misrepresents my position. My problem is not that "the guideline was not promoted without unanimous agreement" but that the guideline was promoted with three editors objecting to it. Instead of trying to find the compromise, the majority ignored the dissenting editors dismissing one as an outlier, another as a crackpot, and third as wikilawer. All my attempts to achieve the compromise were dismissed.


 * My second problem is that this assay is overly prescriptive, and Colin refused to include here the following statement from the WP:NOR policy " Appropriate sourcing can be a complicated issue, and these are general rules. Deciding whether primary or secondary sources are more suitable on any given occasion is a matter of common sense and good editorial judgment, and should be discussed on article talk pages.". He insists that it is self evident. But if it so, why is he so much against it, and why is it included in the WP:NOR. He also rejected outright my proposal to avoid mentioning primary and secondary sources at all and try to structure it along the lines of WP:V. Paul Gene (talk) 23:40, 17 September 2008 (UTC)
 * Paul, I don't have a golden vote. If you have a suggestion that would improve this guideline start a new section and propose it (and keep it focussed on just that suggestion). If you have consensus for its inclusion then it goes in. Advertise the suggestion at WT:MED if you like. Possibly your previous suggestions have been lost in huge dispute sections and haven't had enough eyes or responses. Colin°Talk 08:16, 18 September 2008 (UTC)


 * Duplicating information on multiple pages is deprecated. It leads to problems with keeping pages synchronized, and ultimately leads to conflicts (for examples of which, see most of the discussions at WP:MOSCO right now).  Furthermore, I think that any experienced editor knows that a policy trumps a guideline, so pasting that text from NOR adds no actual value.  WhatamIdoing (talk) 00:12, 18 September 2008 (UTC)


 * Why then you duplicate here the definitions from WP:NOR about primary and secondary sources and other stuff from [WP:RS]]? Why does Colin oppose to removing these definitions? Because the goal of a guideline is to help, so it would be helpful for a reader to have most relevant things in one place, even though they are mentioned elsewhere. Withholding parts that you do not like makes this essay biased, and that is what I am opposed to. Paul Gene (talk) 00:21, 18 September 2008 (UTC)
 * Because we are providing medicine-specific details about how to differentiate between primary and secondary literature, and medicine-specific reasons why one might want to do that. We are not simply pasting in a copy of WP:PRIMARY.  The details that we provide here might be useful for a non-medically qualified Wikipedia editor -- that is, the normal, average editor that wants to do a good job, and needs something more than a link to scholar.google.com to be able to do that.  WhatamIdoing (talk) 00:28, 18 September 2008 (UTC)


 * Paul gene - since when does 'three editors objecting' not equal ' promoted without unanimous agreement' ? This just confuses the request for further opinions. I also see that the line: "Reliable primary sources can add greatly to a medical article, but must be used with care because of the potential for misuse" is in the guideline so some mention has been made at least.LeeVJ (talk) 12:16, 18 September 2008 (UTC)

I think it's a good candidate for a guideline; outside of engineering and computer science, which enjoy a more lateral 'bazaar' kind of approach when it comes to availability of material and the cross-publication of material, as well as active armchair enthusiasts that create a market for secondary publication of research, for the purposes of most non-liberal arts fields, secondary sources are at the very least inaccurate, at worst plain wrong, and usually misleading. I can't stress enough the importance of using primary sources for restatement of fact; in the academic community, simple statements like "This disease has x number of cases a year" can mean several different things; from a statistical standpoint, one could make things "worse" than the other. There are general standards for what means what in academia and medical journals. Secondary publications and media, not so much; they aren't going to go out of their way to discuss prevalence versus incidents, or the details of a specific cross-species mutation. For that, you have to go to the source that matters most.

And there's nothing wrong with that. It's not synthesis if you're just restating material. A lot of people make the mistake of assuming that primary sources automatically mean original research, which simply isn't the case. Primary sources are fine for the simple restartment of fact; its when you start using more than one of them and analyzing the resultant product that it becomes a problem, although I can understand why some people might not quite grasp that yet.

This isn't BLP. We aren't talking about digging up someone's birth records to source their real name. These are reputable academic publications and case studies which are absolutely fine candidates for sources as long as you don't put words in the authors' mouths. That's really all there is to it. Celarnor Talk to me 02:42, 18 September 2008 (UTC)


 * I'm not quite sure I understand your lumping of "secondary publications and the media". Can you give examples of what you are considering as "secondary publications" because I don't think they are the "secondary sources" WP:MEDRS is promoting (high quality reviews in medical journals, respected academic monographs by subject experts, etc). The danger (and it is just a danger, not an absolute mistake) is that in selecting a primary source's "facts" and restating them in simple language on WP, editors can easily fall into all sorts of traps of overstating the importance/relevance/quality of the findings. Far better to cite an expert's peer-reviewed analysis and discussion of the primary literature. We are a tertiary source, after all. Colin°Talk 06:42, 18 September 2008 (UTC)


 * Then they shouldn't be restated into simple language, IMO; Wikipedia is already dumbed down enough. But in any case, when I referred to secondary source, yes, obviously when a peer-reviewed journal article is available, that would be preferable to raw experimental data, but my point was that raw experimental data is fine, too.  <b style="color:#629632;">Celarnor</b> <sup style="color:#7733ff;">Talk to me  18:01, 18 September 2008 (UTC)
 * The use of raw experimental data is considered at least highly suspect by the No Original Research policy: "...historical documents such as diaries, census results, maps, or transcripts of surveillance, public hearings, trials, or interviews; tabulated results of surveys or questionnaires; written or recorded notes of laboratory and field research, experiments or observations, published experimental results by the person(s) actually involved in the research..."  We can't promote the use of a source that a policy specifically calls out as being unacceptable.  WhatamIdoing (talk) 18:36, 18 September 2008 (UTC)


 * I disagree. There is no policy that states the use of primary sources are unacceptable.  There are, however, limits on how they may be used.  Please review PSTS.  <b style="color:#629632;">Celarnor</b> <sup style="color:#7733ff;">Talk to me  19:04, 18 September 2008 (UTC)


 * True, it says instead "Wikipedia articles should rely on reliable, published secondary sources" and "Primary sources that have been published by a reliable source may be used in Wikipedia, but only with care..." I didn't say that the use of primary literature is entirely prohibited.  The fact of NOR's clear preference for articles being based on secondary sources, however, is undisputable.  WhatamIdoing (talk) 20:09, 18 September 2008 (UTC)


 * Secondary sources are not always sufficient, especially in scientific fields where the common media has issues reporting all of the facts. Besides, it says that deciding what type of source to use in a given situation is a matter of common sense and editorial judgement; you shouldn't exclude them solely on the basis of not being written by a newspaper shill, or because a peer-reviewed journal edited a thesis that differs from the original version, or because a peer-reviewed version of the paper won't be published until next quarter.  No one's advocating that we should rely on primary sources for articles; I'm only saying that there are places where primary sources are better than secondary sources, and I'd like to see that reflected in a guideline.  Medical journals are obviously important sources for medicine-related articles; throwing them out the door en masse simply because they're primary sources doesn't make sense; its a decision that should be made on a case by case basis using all the information available.  We're here to build an encyclopedia, not to aggregate news.  <b style="color:#629632;">Celarnor</b> <sup style="color:#7733ff;">Talk to me  21:23, 18 September 2008 (UTC)


 * And where does MEDRS "throw them [primary sources] out the door en masse"? You say "I'd like to see that [places where primary sources are better than secondary] reflected in a guideline" Well the guideline does say "Reliable primary sources can add greatly to a medical article". Yes, unfortunately there are some people who are "advocating we should rely on primary sources for articles": that's one of the issues raised. I rather think this is all arguing for arguments sake and folk have completely forgotten (or maybe never read properly) what this guideline says and what "guidelines" are for and their implicit limitations. Colin°Talk 22:53, 18 September 2008 (UTC)


 * You should probably re-read my comments, since you seem to be extremely confused about what I said; not having this as a guideline would raise the bar for the use of primary sources to support an article, not the other way around. Naturally, primary sources aren't inherently more valuable, but there are times when secondary media is insufficient, especially in medicine, which has an extremely hiearchal, top-down approach; it isn't like the lateral publishing you get in CS or most engineering fields, where the data is pretty much republished in full, even in secondary media.  I think that having this would give people something to point at when they're citing experimental data where the secondary media opted not to, or failed to make a distinction that an original report did, and what not.  <b style="color:#629632;">Celarnor</b> <sup style="color:#7733ff;">Talk to me  15:16, 19 September 2008 (UTC)


 * I'm afraid I'm having trouble following Celarnor's comments as well. (But I'll chime in anyway. :-) In a field like medicine that has high-quality secondary sources, it's unwise to second-guess those sources in a Wikipedia article. If secondary sources omit discussion of an older primary source, or downplay that source, or highlight only part of the source's results, then it's better for the Wikipedia article to follow their lead. To do otherwise is to argue with the published experts in the field, which is not the Wikipedia editors' job. Eubulides (talk) 17:41, 19 September 2008 (UTC)


 * Eubulides, that is all true, but I think that Celarnor's complaint is that MEDRS's explanation of WP:PRIMARY, read in isolation from its equally important "be careful about premature or incomplete popular press reports" section, could result in citing a popular press report about novel experimental results when you would never cite the actual scientific study. Of course, when you combine the two sections, it's reasonably obvious to me (and doubtless to you, and to many other editors) that "don't include that tentative information at all, or mark it as being unconfirmed" is the right course of action.  WhatamIdoing (talk) 18:30, 19 September 2008 (UTC)


 * If that's Celarnor's complaint, then I don't understand how the confusion could occur. The definition of primary sources in WP:MEDRS rightly does not include popular press accounts about new experimental results. Perhaps you could explain the possible confusion by proposing improved wording that eliminates it? Eubulides (talk) 19:44, 19 September 2008 (UTC)


 * I'm not confused. :P  <b style="color:#629632;">Celarnor</b> <sup style="color:#7733ff;">Talk to me  01:42, 20 September 2008 (UTC)


 * Papers published in reputable journals, theses published via academic presses and the like should be considered reliable sources; I don't quite understand why there are people who would want to elevate a 2-column blurb by a non-practicing coulumnist with an MD in the Joe Weekly Times above a detailed, twelve-page case study published in the JAMA; naturally, it isn't the be-all and end-all of sourcing; it probably isn't a good idea to keep around material that isn't ever likely to be reported on in secondary media, and the article should never be in the position of synthesizing differences between sources without another source upon which to base a difference analysis, but it only seems obvious to me that the paper itself should at least be cited along with the Joe Weekly Times. <b style="color:#629632;">Celarnor</b> <sup style="color:#7733ff;">Talk to me  18:49, 19 September 2008 (UTC)


 * WP:MEDRS covers that point, by saying "A news article should not be used as a sole source for a medical fact or figure. Editors are encouraged to seek out the scholarly research behind the news story. One possibility is to cite a higher-quality source along with a more-accessible popular source, for example with the "laysummary=" parameter of the Cite journal template." Is there something here that is not clear, or which could be worded better? If so, can you propose improved wording? Thanks. Eubulides (talk) 19:44, 19 September 2008 (UTC)


 * No, I think it's perfect as it is... you do realize I support the guideline, right? I'm not talking about the page, I'm talking about the people who oppose it on the basis of "Oh noes, primary sources!!111elventy".  <b style="color:#629632;">Celarnor</b> <sup style="color:#7733ff;">Talk to me  21:54, 19 September 2008 (UTC)


 * I suggest the situation might be clarified by replacing the term, "primary sources" here by the term "primary research publications", When scientists use that term primary sources for these, its really a specialised use. The primary sources for research in medicine are the records of trials and experiments in laboratory notebooks and databases., the research publication are the first published material, and are therefore in a sense primary, but not in these sense of documentary records used by historians. DGG (talk) 16:42, 24 September 2008 (UTC)


 * Yeah, I think that's a source of a lot of confusion; its primary in the sense that it is written by the originator of the experiment/clinical trial/whatever, but it is being presented in a format that is meant for publication and archiving; it isn't the same thing as citing the page of the guy's lab notebook with the coffee stain and the molecule diagram. <b style="color:#629632;">Celarnor</b> <sup style="color:#7733ff;">Talk to me  16:50, 24 September 2008 (UTC)

Continued edit warring
Paul,

If you are edit warring because then that is truly lame. Take a break. Think about what wording changes would make you happy(ier). Post them here in a new section. If you fail to get consensus approval for those changes then give it a rest will you! Forget debating the meaning of consensus. Few people agree with you and fewer still are at all interested. Lay off the undo button! Colin°Talk 13:09, 19 September 2008 (UTC)
 * 1) The text doesn't repeat WP:NOR in saying the bl**dy obvious: "Appropriate sourcing can be a complicated issue, and these are general rules. Deciding whether primary or secondary sources are more suitable on any given occasion is a matter of common sense and good editorial judgment, and should be discussed on article talk pages."
 * 2) You think most people here have got their definition of "consensus" wrong


 * I agree, and reverted Paul gene's removal of the tag. Please see below for proposed wording that I hope fixes the problem. Eubulides (talk) 17:30, 19 September 2008 (UTC)
 * Colin, check any dictionary for the definition of consensus and you will understand that most MEDRS people got it wrong. Check the WP:CONSENSUS policy, which you called irrelevant, and you will see that most MEDRS people got the policy wrong too. Paul Gene (talk) 23:31, 19 September 2008 (UTC)


 * Unfortunately, Eubulides continues the edit war by giving this essay guideline status. I have to restore the status quo. On the positive side, he tries to discuss the issues I raised on the Talk page. The collaboration hand should now be extended to other dissenting editors. The general issues raised by EverSince and Mihaj, as to how this overly long and confusing essay improves the Wikipedia and whether we need it as a guideline when we already have WP:V, WP:RS and WP:NOR should be addressed. The radically shortened and specific to medical articles version can then be legitimately promoted to guideline. Paul Gene (talk) 12:47, 20 September 2008 (UTC)


 * I too dispute that we have consensus for this as a guideline. My own position is similar to that of other editors who see this as unnecessary proliferation of rules contrary to WP:BURO and WP:CREEP.  What I've not seen in a survey of the discussions above is some concrete examples of where this putative guideline would have made a difference.  Are there any? Colonel Warden (talk) 19:58, 20 September 2008 (UTC)
 * Many medical articles use WP:MEDRS and have benefited from its use. Examples that I've contributed to include Autism, Asperger syndrome, and Tourette syndrome. Non-medical articles have benefited too; an example I've contributed there include Samuel Johnson and Daylight saving time. I've contributed to many articles, I don't know of any that would have been hurt by this being a guideline. Do you? Eubulides (talk) 22:05, 20 September 2008 (UTC)
 * I would add that these guidelines are essential to areas like AIDS denialism and abortion and mental health, both of which have seen concerted efforts to mine the primary literature to undermine widely accepted expert opinion. I'm happy to list areas where these principles are vital to the creation of a serious, respectable reference work. I would agree with Eubulides, and second his examples as well; the need for these sorts of principles is quite clear. Whether a separate guideline is required is, I suppose, debatable, but the significance of the problem seems to outweigh theoretical concerns about "instruction creep". MastCell Talk 22:08, 20 September 2008 (UTC)
 * Eubulides, the question was not about the articles you contributed to but whether using other guidelines instead of WP:MEDRS would have been just as good. Sandy, who is a regular contributor to autism, asperger and tourette articles, in her comments on Rfc stated that, although she supports this essay as a guideline, it mostly repeats other policies, and does not change much. Paul Gene (talk) 01:51, 21 September 2008 (UTC)
 * If you're an expert on writing medical articles for Wikipedia, as SandyGeorgia is, then indeed it doesn't add much; it mostly just restates the obvious. But that doesn't mean it shouldn't be a guideline. For the articles I've contributed to, WP:MEDRS was quite helpful. I did not start out as an expert. Eubulides (talk) 19:37, 21 September 2008 (UTC)
 * Unfortunately, a lot of what this essay actually adds to the existing guidelines is harmful. The featured medical article which would have been harmed by the anti-popular press bias of this essay is Baby Gender Mentor. Another featured med article bupropion would have been harmed by the anti-research papers bias of this essay. The list can go on and on. Paul Gene (talk) 02:08, 21 September 2008 (UTC)
 * Could you be more specific about that? Exactly which text would WP:MEDRS exclude from Baby Gender Mentor and bupropion? Eubulides (talk) 19:37, 21 September 2008 (UTC)


 * geez - looks like we have a decent consensus going that this page should remain (or be reverted to) essay status. I support that move. -- Ludwigs 2  21:31, 20 September 2008 (UTC)
 * There is clearly no consensus for removing the guideline tag. Please see for consensus and  for later discussion. There is no consensus there for removal there. Eubulides (talk) 22:05, 20 September 2008 (UTC)
 * well, since there was no proper consensus for adding it, I guess that makes us even.   -- Ludwigs 2  22:12, 20 September 2008 (UTC)
 * What is this if not "proper consensus." And what is 2 weeks of uncontested guideline status if not consensus implied by silence? And finally, what should we make from the fact that this dispute has gotten no attention over at the village pump? Looks like consensus to me. Yilloslime (t) 22:31, 20 September 2008 (UTC)
 * This essay appeared to be uncontested for two weeks because I did not want to start an edit war. I took some time to think about it, and in good faith I tried to understand the reasons DavidRuben had for ignoring the dissenting editors, see . Paul Gene (talk) 01:35, 21 September 2008 (UTC)
 * If there was a consensus then we wouldn't be having this discussion. Colonel Warden (talk) 07:10, 21 September 2008 (UTC)
 * OK....but what about my other 2 points? Yilloslime (t) 09:08, 21 September 2008 (UTC)

Baby Gender Mentor
I ran through Baby Gender Mentor to see what impact this guideline's popular press advice, if strictly enforced, would have on it. Here's the only change that would need to be made: "If there is no Y chromosome, the embryo is female.[2]"  This undisputable fact probably doesn't need to be sourced at all, but it would probably be better to cite to a scientific publication (e.g., a biology textbook for twelve year olds) instead of "Newhouse News Service".

This is not a beautifully referenced article; it includes citations for Blogspot and About.com, and a remarkable number of websites that are selling the product in question. Most of the article is dueling quotations from various supporters and detractors over the various lawsuits that have been filed against the company over errors and the potential for abusing the test (e.g., aborting girls).

I do not see any harm that this guideline would have done to this article. Paul, can you give a specific example of how a popular press article is used in that article, that you think would not have been allowed under this guideline as currently written? WhatamIdoing (talk) 06:18, 21 September 2008 (UTC)


 * The source in question seems fine to me. If the putative guideline would cause nitpicking of this sort then I'm dead against it.  It's hard enough getting articles sourced already without more obstacles being raised.  The topic also indicates that there would be boundary issues like medical ethics.  We're seing a lot of objection to subject-specific guidelines in the area of notability because they lead to complexity and inconsistency.  Having subject-specific guidelines for verification is likewise a bad idea. Colonel Warden (talk) 07:10, 21 September 2008 (UTC)
 * I disagree. The fact that some editors provide no sources, or that a weak source is better than no source, does not argue in favor of providing no advice on what might make a better source.  The logic behind your argument is the same as "It's hard enough to prevent drunk driving, so let's quit worrying about excessive speeding among sober drivers."  BTW, the nine subject-specific guidelines for notability have been around and widely supported by regular editors for years, and barring the current edit war at WP:Notability (fiction), (as I understand it, one editor wants to be able to write about favorite books despite the lack of any independent, third-party reliable sources), I've never heard of any opposition to them that didn't appear at AfD by a person with a clear conflict of interest, which is hardly "a lot of objection".  WhatamIdoing (talk) 15:22, 21 September 2008 (UTC)
 * BTW, I added the disputedtag to the relevant sections. This will help identify the areas of concern to any newcomers.  WhatamIdoing (talk) 16:41, 21 September 2008 (UTC)


 * Terribly sorry to be adding this so late. I just saw this.  Note in the FAC for Baby Gender Mentor no support from me, and that article would not pass FAC today.  Absolutely, about.com does not get by FAC today unless the author is shown to meet our WP:SPS standards.  For the source in question,  the author's qualifications to write about medical topics (click on her profile) are ... ta da !  She is a graphics designer and the mother of twins !  No, this would not pass FAC today and is not an acceptable source for medical information. The problem with about.com is that they allow just about anyone to write on anything, and while they do have some experts who meet our WP:SPS policy, they are simply not widely accepted as a reliable source at FAC, and there is almost always a better source available.  If that was used as an example here, it's an example of exactly what we want to avoid.   A mom becomes a medical expert on twins because she has twins and signed up to write for about.com, who takes everybody and the kitchen sink.  Sandy Georgia  (Talk) 21:07, 30 September 2008 (UTC)


 * Actually, the abovementioned Baby Gender Mentor source has a more serious problem: it doesn't support the claim that cites it. The source is mainly intended to support the following claim in the immediately preceding part of the paragraph: "Acu-Gen explains the test works by detecting fetal cells that have entered the woman's bloodstream through fetomaternal microchimerism. The company performs two tests: the first is a quantitative polymerase chain reaction and the other is proprietary. The sample is tested for DYZ-1, a repetitive sequence found on the Y chromosome, which is present only in males." But the cited source is entirely inadequate for that claim, as it does not mention fetomaternal microchimerism, polymerase chain reaction, or DYZ-1. If this is supposed to be an example of a "good" claim that WP:MEDRS would exclude, I'm afraid that it is lacking, as it is poorly sourced by any standard. Eubulides (talk) 19:37, 21 September 2008 (UTC)
 * Well, Baby Gender Mentor is a featured article of the WP:Medicine project, and as such represents its best work. So, your views are at odds with the community views. The problem of the majority is that in the WP:MEDRS essay they tried to prescribe things that "ought to be" instead of checking what are the best practices in the community. The WP:PG policy recommends this as the preferred way of constructing guidelines: "Documenting actual good practices and seeking consensus that the documentation truly reflects them." Another recommendation of WP:PG, which the majority keeps violating is this: "A 'failed proposal' is one for which consensus for acceptance has not developed after a reasonable time period. Consensus need not be fully opposed; if consensus is neutral or unclear on the issue and unlikely to improve, the proposal has likewise failed. It is considered bad form to hide this fact, e.g. by removing the tag. Making small changes will not change this fact, nor will repetitive arguments. Generally it is wiser to rewrite a failed proposal from scratch and start in a different direction." Paul Gene (talk) 23:51, 21 September 2008 (UTC)
 * Well, Baby Gender Mentor is a featured article of the WP:Medicine project, and as such represents its best work. So, your views are at odds with the community views. And if this is the sort of logic going on here, no wonder this discussion is so long. How many med editors supported that article's FAC?  It would not get through FAC today, and rhetoric like "your views are at odds with the community views" is neither helpful nor correct.  Submit the article to WP:FAR and you'll find that about.com won't fly.  FAC has become much more rigorous about checking sources in the last year (ahem).  Sandy Georgia  (Talk) 21:11, 30 September 2008 (UTC)
 * BGM was approved as FA in January 2007. It was tagged for WPMED two months later.  As far as I can make out, its major editors were not WPMED members.  So it falls (barely, IMO) within our scope:  that tells you something about the subject, not the authorship.  It's FA status represents some of Wikipedia's best articles.
 * And like I said: I looked at every single popular press article identified in the references.  IMO only one would need to be changed to get 100% compliance with the popular press advice given here (and, as it turns out, the source failed verification and needs replacing anyway).  Again:  You assert that this article would be harmed by MEDRS's advice.  Would you please identify a single, specific use of popular press in this article that you think is non-compliant with the popular press advice given here?  Alternatively, if closer inspection inclines you to think that MEDRS would not, in fact, harm this article, are you willing to retract your assertion that it would?  WhatamIdoing (talk) 04:15, 22 September 2008 (UTC)
 * I tagged BGM for this citation problem and discussed this tag on BGM's talk page, where I suggest further discussion on that citation should talk place. As that citation has issues that are independent of WP:MEDRS, let's look for less-problematic examples of where WP:MEDRS would hurt a medical article. Eubulides (talk) 22:35, 23 September 2008 (UTC)

Edit warring - page protected
Paul - as your quote so correctly states on failed proposals: "if consensus is neutral or unclear on the issue". Yet there was overwhelming majority in the consensus seeking of the RfC, and multiple (4 other) editors restored guideline tag in the last few days. Repeatedly removing the guideline-tag (13 September, 14 September, 18 September, 19 September, 20 September, 00:34, 22 September & 00:53, 22 September) is therefore edit warring - I've protected the page until consensus can be demonstrated over either demoting the guideline or on rewording issues. If WP:RS has preference for secondary sources then nothing in this should go against that, a preference for primary is therefore not a reason to block this as a guideline (were WP:RS to be demoted, then such an argument would be appropriate).

From prior points with Paul from my talk page: as the essay How to contribute to Wikipedia guidance notes: "Votes are rarely appropriate for policy debates, and almost never for guidelines. A vote can never create consensus, instead it may or may not indicate existing consensus", yet the RfC had a 84.2% approval rating. By comparison the first Wikipedia policy (which needs even greater agreement than just guidelines) of WP:IAR had 86.7% approval rate (The Charms of Wikipedia) with 3 less editors contributing to its discussion than WP:MEDRS's. In comparison to WP:RS which had a drafting period of 28 February to 12 May 2005 (2.5 months), a fraction of WP:MEDRS drafting 10 November 2006 - 2 September 2008 (22 months) and repeatedly cited by editors in discussion prior to the RfC.

Finally, as guideline tag-boxes state: "It is a generally accepted standard that editors should follow", and "generally accepted" does not try to imply "universally accepted", and as such no guideline in Wikipedia claims to be 100% unanimous agreement. Indeed policies header-tags only claim to be "widely accepted standard that all editors should follow" (noted "should" rather than "must" or "always"), for the first policy of guidelines are considered more advisory" David Ruben Talk 02:58, 22 September 2008 (UTC)


 * David's action seems improper in that he is using his admin tools in support of his position regarding a content dispute.  As for consensus, compare Articles for deletion/Deletionpedia which was recently closed as no consensus even though there was a considerable numerical preponderance of keep.  Consensus does not mean we count heads. It requires that the major arguments be resolved. Colonel Warden (talk) 06:10, 22 September 2008 (UTC)


 * DavidRuben was the one who took the wrong decision to promote this page against the objections of three editors; now he compounds his mistake by taking sides. According to the WP:PG policy, even one neutral voice is sufficient to fail the proposed guideline: "Consensus need not be fully opposed; if consensus is neutral or unclear on the issue and unlikely to improve, the proposal has likewise failed. It is considered bad form to hide this fact, e.g. by removing the tag."

Common sense
Paul gene's most-recent objections seems to be that this page ought to repeat the point Colin says is "obvious". There is some merit to the point that what is obvious to us might not be obvious to new Wikipedia editors, so I propose to address this point by inserting the following at the start of WP:MEDRS:
 * Choosing among sources involves common sense, editorial judgment, and discussion on article talk pages.
 * The new "Choosing" sentence would become the topic sentence of that section, and the Further template would point to WP:PSTS so that readers can easily find the guiding policy here.
 * The new "Choosing" sentence would become the topic sentence of that section, and the Further template would point to WP:PSTS so that readers can easily find the guiding policy here.

Eubulides (talk) 17:30, 19 September 2008 (UTC)


 * How about,

To this: "In general, Wikipedia's medical articles should be based upon published, reliable secondary sources whenever possible. Reliable primary sources can add greatly to a medical article, but must be used with care because of the potential for misuse. For that reason, edits that rely on primary sources should only make descriptive claims that can be checked by anyone without specialist knowledge. Where primary sources are cited, they should be presented in a manner which hews closely to the interpretation given by the authors or by published, reliable secondary sources. Primary sources should not be cited in support of a conclusion which is not clearly adduced by the authors or by reliable secondary sources, as defined above.

Add this:

"Appropriate sourcing can be a complicated issue, and these are general rules. Deciding whether primary or secondary sources are more suitable on any given occasion is a matter of common sense and good editorial judgment, and should be discussed on article talk pages."(see Wikipedia:No original research) Paul Gene (talk) 23:12, 19 September 2008 (UTC)


 * Eubulides, and of course I applaud your initiative. I'd accept your extended hand. Paul Gene (talk) 23:33, 19 September 2008 (UTC)

That is just a clone of the last paragraph of WP:PSTS, and it's overkill here. My proposal, essentially, is to use WP:SUMMARY style on that paragraph, and to precede the summary with a "Further" notice to direct readers to the full policy section. That's better than copying policy paragraphs bodily into this section. My proposal would mention this point quite prominently, at the start of its section, in a brief paragraph all to its own, together with a promenint "Further" notice; this would compensate somewhat for its relative brevity. Eubulides (talk) 02:28, 20 September 2008 (UTC)


 * It would be logical to have the counterpoint to the prescriptive "must", two shoulds and one should not of the quoted paragraph, right after it. And the style in which the qualification is written in WP:NOR is really good. So I do not see anything bad in cloning it. For brevity, we could omit "should be discussed on article talk pages." which is really obvious. So instead of

...reliable secondary sources, as defined above.(see Wikipedia:No original research)

we would have:

''...reliable secondary sources, as defined above. Appropriate sourcing can be a complicated issue, and these are general rules. Deciding whether primary or secondary sources are more suitable on any given occasion is a matter of common sense and good editorial judgment (see Wikipedia:No original research).''

This version is only five words longer than the summary you are proposing. Paul Gene (talk) 05:09, 20 September 2008 (UTC)


 * The summary I proposed adds 14 words of text, plus 7 words of hatnote. The summary you most-recently proposed adds 40 words of text; that's considerably more than five words longer. WP:PSTS's last paragraph is a fairly small tail on a fairly large dog of a section. The intro to WP:MEDRS, which is a summary of WP:PSTS, should not emphasize the tail at the expense of the dog, particularly when it has nothing to add to the tail. Eubulides (talk) 06:26, 20 September 2008 (UTC)


 * I did not count articles and prepositions. But OK. The MS Word counts you proposal as adding 21 word, and mine adds 35. What is 14 words for this long assay? Paul Gene (talk) 12:32, 20 September 2008 (UTC)


 * Yours adds 40 words, if one counts the 5-word parenthesized note at the end. Mine now adds 14 words, since the hatnote is already there now. My wording covers all the basic points, using the WP:SUMMARY style; there is no need to duplicate here the longer version, which is taken from the policy section that we are summarizing. The point is not just the word count: it's the emphasis. A 40-word duplication in this relatively short section is overemphasizing this point here. Eubulides (talk) 19:43, 21 September 2008 (UTC)

Wikilink to WP:PSTS
The discussion in suggests that a wikilink to WP:PSTS should be placed into WP:MEDRS; this is independent of the other changes discussed. I propose adding:

at the start of WP:MEDRS. Eubulides (talk) 06:26, 20 September 2008 (UTC)
 * Sounds okay to me. I think this is substantially better than duplicating text already present elsewhere.  WhatamIdoing (talk) 18:31, 20 September 2008 (UTC)

Administrator's poor judgement and improper actions
1.    David Ruben improperly promoted this page to a guideline against the objections of three editors, see Wikipedia_talk:Reliable_sources_(medicine-related_articles). In doing this he violated WP:CONS policy, which states:


 * "In the case of policies and guidelines, Wikipedia expects a higher standard of participation and consensus than on other pages."


 * "Developing consensus requires special attention to neutrality - remaining neutral in our actions in an effort to reach a compromise that everyone can agree on."


 * "Minority opinions typically reflect genuine concerns, and their (strict) logic may outweigh the "logic" (point of view) of the majority. New users who are not yet familiar with consensus should realize that polls (if held) are often more likely to be the start of a discussion rather than the end of one."

2.   By promoting this page he also violated WP:PG policy, which requires even higher level of consensus for proposed guidelines:


 * "A failed proposal is one for which consensus for acceptance has not developed after a reasonable time period. Consensus need not be fully opposed; if consensus is neutral or unclear on the issue and unlikely to improve, the proposal has likewise failed. It is considered bad form to hide this fact, e.g. by removing the tag. Making small changes will not change this fact, nor will repetitive arguments. Generally it is wiser to rewrite a failed proposal from scratch and start in a different direction."

3.  Following WP:PG guideline, I placed the "Failed" tag on this proposal. David Ruben reverted the "Failed" tag in the direct contradiction to WP:PG guideline.

4.  David Ruben misused the administrator's tools by protecting this page. He has a dispute with me and other editors regarding his decision to promote this page, see Wikipedia_talk:Reliable_sources_(medicine-related_articles) and User_talk:Davidruben.


 * Administrators policy states:
 * "Common situations where avoiding tool use is often required: Conflict of interest/non-neutrality/content dispute — Administrators should not use their tools to advantage, or in a content dispute (or article) where they are a party (or significant editor), or where a significant conflict of interest is likely to exist. With few specific exceptions where tool use is allowed by any admin, administrators should ensure they are reasonably neutral parties when they use the tools."

Paul Gene (talk) 10:37, 22 September 2008 (UTC)

Take this elsewhere. Colin°Talk 11:24, 22 September 2008 (UTC)}}


 * Request for review of this is fine, and probably to be welcomed given lengthy discussions over several pages over definition of consensus and process for guideline determination. Hence review sought at WP:AN/I :-) David Ruben Talk 12:47, 22 September 2008 (UTC)


 * Colin, per WP:Talk, if you want to change the thread header, "To avoid disputes it is best to discuss changes with the editor who started the thread". Also, I believe that this discussion is relevant to the article. Per WP:Talk: "The talk page is also the place to ask about another editor's changes." Which is what I am doing - commenting on the changes other editor made. Paul Gene (talk) 11:54, 23 September 2008 (UTC)
 * David, you have chosen an incorrect venue to discuss your actions. Administrator's actions related to page protection should be discussed at Requests_for_comment/User_conduct. That is what I have done.:-) Paul Gene (talk) 12:06, 23 September 2008 (UTC)


 * Davidruben deleted part of his reply to me. When I restored it, he deleted it again, arguing that "here an editor alters their posting (provided does not impinge on a reply), height of disrespect to edit back, also poor to insert comment of same indent level)". The WP:Talk states: "It is best to avoid changing your own comments. Other users may have already quoted you with a diff (see above) or have otherwise responded to your statement. Therefore, use "Show preview" and think about how your amended statement may look to others before you save it." I already quoted his reply with a diff at Rfc, so it is undesirable for him to change his comments :). For the record, here I quote his comment in full.
 * "Hmmm. x7 reverts by single editor restored by 4 other editors, seemed to equate to edit warring and risking a block, but as not sole dissenting opinion seemed best to protect page instead; albeit at risk of "the wrong version". WP:PG states "if consensus is neutral or unclear on the issue", but this goes to heart of your objection that consensus is unanimous or not at all, but guideline-tag only states "generally accepted" (RfC was 84.2%) which is not absolute and no obligation.
 * Request for review of this is fine, and probably to be welcomed given lengthy discussions over several pages over definition of consensus and process for guideline determination. Hence review sought at WP:AN/I :-) David Ruben Talk 12:47, 22 September 2008 (UTC)"""" Paul Gene (talk) 10:08, 24 September 2008 (UTC)


 * I asked David to revise his text, which had not at that point been quoted by a diff. The reason was that it was a continuation of discussion of editor behaviour which is not appropriate for this talk page. Can I once again ask that this section be closed to further comment. Talk about David's admin actions elsewhere. Further comment on this talk page should be about the text of the guideline. Colin°Talk 11:20, 24 September 2008 (UTC)


 * Revision of my 13:47, 22 September 2008 posting was 14:16, 22 September 2008, RfC/User created 04:05, 23 September 2008. David Ruben Talk 12:18, 24 September 2008 (UTC)

Steps towards consensus
suggested on Wikipedia talk:Consensus that those editors discussing contentious issues at WP:MEDRS answer four questions:
 * Your current position as to how MEDRS should be formulated (and reasoning why)
 * Some idea of where you're willing and able to compromise on that position.
 * Your current view/ best estimate of where each of the other participants stand, singly and as a group (and reasoning why).
 * Your current best estimate of where other participants are willing to compromise.

The idea hasn't been followed-through but may be worth exploring. Colin°Talk 12:38, 25 September 2008 (UTC)

Colin's answers

 * My position:


 * MEDRS should be in agreement with WP:PRIMARY in regarding secondary sources as the foundation of an article, and to use primary sources only with care. This policy is manifest in this guideline where we prefer to cite literature or systematic reviews rather than research papers. I note that some people have commented that there is a different definition of "primary source" within science (logbooks and database records); I'm using the definition on WP which is concerned solely with published material.
 * MEDRS should be in agreement with WP:V, which places peer-reviewed journals and academic books at the top of the quality tree, and mainstream newspapers at the bottom. ("In general, the most reliable sources are peer-reviewed journals and books published in university presses; usually followed by university-level textbooks; then by magazines, journals, and books published by respected publishing houses; then by mainstream newspapers."). WP:RS (or its example page) have long said that "popular newspaper and magazine sources are generally not reliable sources for science and medicine articles".
 * MEDRS does not need to spell out where editors should use common sense, judgement or talk pages. We have WP:IAR and other editor-behaviour guidelines for that. The whole guideline should be read in the context that it is merely a guideline, and is a part of a set of guidelines and policies that work as a whole.


 * My compromise:


 * I'm not sure how the core of the first two points can be changed without bringing MEDRS into conflict with policy. A few editors have expressed support for the New York Times but since I don't read it, I can't judge. I don't believe any British newspaper has shown itself capable of reporting medical information reliably. Even if judged reliable, other aspects of a newspaper article make it a poor choice for anything but the most trivial medical fact. The exact wording used to express these guidelines is, of course, open to discussion. The third point can be compromised if there is consensus that MEDRS needs to spell out what some regard as obvious or repetative.


 * Others' position:


 * Paul regards the preference for reviews over original publications as "batty" because they are "written by the same people who do the original research, and they are subject to the same personal prejudices and biases". Therefore they should not be favoured. In addition, he would like the choice of secondary vs primary to emphasise the need for common sense, editorial judgement and discussion on talk pages.


 * Nbauman objected to how newspapers were regarded, though did not participate in the poll. Some effort was made to find a compromise wording that would be acceptable. A debate ensued where Nbauman believed this guideline's statements needed to be sourced per WP:V rather than be the collective opinion of WP editors. It was established that this requirement does not exist, but even if it did, sources could be found to support the idea that newspapers are not a good choice for medical facts. A compromise was reached with Nbauman where this statement was explicitly sourced in the guideline, even though such sourcing is not required. Ludwigs2 was another editor who objected to the anti-newspaper stance.


 * Others' compromises:


 * Paul has suggested (on my talk page) highlighting the danger in using reviews written by authors with a COI over the original research they are citing. I responded that this sounds like a valid concern, but very difficult to detect or enforce, and only necessary where the subject is controversial. Perhaps this idea can be explored by other editors. I have encouraged Paul to make this suggestion to a wider audience; he has not done so yet.


 * I get the impression that most examples given for valid use of newspapers involve some kind of scandal (e.g., Vioxx). Newspaper journalists can do investigative reporting, and medical journals generally do not. Perhaps those editors would be happier if the scope of "avoid newspapers" was clarified and restricted. For example, there seems little problem citing newspapers for historical events, current affairs, social and political issues (e.g., that a drug isn't available on the NHS due to a ruling by NICE), etc.

Please add your own subsection and we can then discuss the opportunities for compromise or changing-of-minds that arise. Colin°Talk 12:38, 25 September 2008 (UTC)

Excellent. Could Paul, Ludwigs2 and WhatamIdoing also reply? (Eusebus, Nbauman and others who would also like to post a similar text may do so too of course, it's still a wiki ;-). Don't worry if your version is substantially shorter or longer than Colin's version. As long as each of the 4 key questions are answered as best you can.) --Kim Bruning (talk) 16:45, 25 September 2008 (UTC)

Colin: your answer to 1 lists requirements, but I'm not sure what to do with them. Can you explain what you would like to change about the page right now? --Kim Bruning (talk) 21:30, 25 September 2008 (UTC)
 * I'm happy with the current text and it meets those requirements and my present understanding of medical sources. That doesn't mean I'm not open to being educated further or that I think the text is perfect. Colin°Talk 21:39, 25 September 2008 (UTC)
 * Ok, noted! :-) --Kim Bruning (talk) 22:40, 25 September 2008 (UTC)
 * Right. If Eubulides made the changes he proposes below, which of those changes would you *not* agree with, and why? Would you update your answers to the questions (especially 3 and 4) based on the data from Eublides? --Kim Bruning (talk) 21:23, 26 September 2008 (UTC)
 * Kim, the idea that you're trying to mediate between me and Eubulides is really funny. Colin°Talk 21:40, 26 September 2008 (UTC)
 * Meh, there's discrepancies between his position and yours right now. If you agree with his position entirely, that's fine, and all I need to know. :) --Kim Bruning (talk) 22:05, 26 September 2008 (UTC)
 * You said you'd support improvements. :-) Are some of the changes that Paul Gene proposes actual improvements? If so, can you specify which? --Kim Bruning (talk) 19:05, 30 September 2008 (UTC)

Eubulides' answers
Eubulides (talk) 17:12, 25 September 2008 (UTC)
 * 1) MEDRS should supplement WP:RS, WP:OR, and WP:V with advice specific to biomedical articles, advice that is in agreement with the mainstream scientific consensus on medicine and biology. MEDRS should not unduly repeat the policy pages, nor restrict itself to merely saying what the policy pages say. Nor should it emphasize parts of the policy that we like and deemphasize the parts we don't like.
 * 2) It's OK to have brief summaries of what the policy pages say, to establish context.
 * 3) There are two overlapping sets of disagreements. One set disagrees with the current standing of newspapers in WP:MEDRS, and would like newspapers to be viewed more highly as a source. Another set disagrees with WP:MEDRS's strong position on favoring secondary over primary sources.
 * 4) above explores one way to compromise over the secondary-versus-primary dispute, by briefly summarizing the policy page in question. It's possible a compromise may be found there. For newspapers, it may be helpful to give another example or two where citing newspapers is OK.
 * Ok, also wondering about your #1, which changes should be made to the current page to meet your requirements? (answers to all 4 questions should be about concrete actions, but let's start at #1). --Kim Bruning (talk) 21:32, 25 September 2008 (UTC)
 * For #1, it's not so much a question of meeting requirements, as it is of improving the article so that it's more useful, particularly to editors new to Wikipedia's medical articles. Here are a few suggestions off the top of my head:
 * Remove the dispute tags.
 * Give advice that's specific to the section of the medical article. Sources for an Epidemiology section will have different characteristics than sources for a Classification section.
 * Give more examples.
 * Make the section headers shorter. Use fewer section headers.
 * Article type is out of place; it should be combined with the secondary sources bullet of Definitions somehow.
 * Periodicals, Books, and Online should be combined into a single top-level section, with duplicative material removed. Almost everything's online now, for starters.
 * Assess the quality of evidence available contains too much detail about evidence ranking schemes. It should summarize the point and give pointers to the details.
 * Eubulides (talk) 23:30, 25 September 2008 (UTC)
 * Ok, compare what you've written with the objectives written by Colin above (answers 1 and 2). Do you foresee Colin objecting to any of your changes? If so, why, and where do you believe you can reach a compromise? --Kim Bruning (talk) 21:25, 26 September 2008 (UTC)
 * Colin might object to some of those proposals; if so, I'd almost surely withdraw them, as Colin has more experience in this area and is a topflight editor. But I must say that it sounds like there's some confusion here, as Colin and I weren't disagreeing with each other. We were disagreeing with other editors, notably with User:Paul gene. Eubulides (talk) 21:39, 26 September 2008 (UTC)
 * Sure, noted. I guess you can tell I'm a neutral outsider here, since I'm just doing this systematically :-) --Kim Bruning (talk) 22:07, 26 September 2008 (UTC)


 * Alright, Paul Gene has pointed out his views now. Can you point out which changes that he proposes that you agree with? --Kim Bruning (talk) 19:04, 30 September 2008 (UTC) hopefully there's at least 1 :-)
 * I don't agree with the changes Paul gene proposes. The "compromise" in is not a compromise: it simply restates Paul gene's position, which is to remove guideline status from this page. The "compromise" also restates Paul gene's position to duplicate large chunks of text from a policy page, even though this would introduce redundancy and makes this page unbalanced. Paul gene has proposed these two changes many times, without anything remotely approaching consensus. In, I attempted a compromise on the second issue, involving a WP:SUMMARY of the policy-page text, but so far this compromise has been rejected. Eubulides (talk) 20:13, 30 September 2008 (UTC)
 * Ok, noted. So there is no change proposed so far, (however small), that you agree with?
 * Alright. based on Pauls position, is there any (small) change you could propose that you could both agree on? --Kim Bruning (talk) 20:21, 30 September 2008 (UTC)
 * I have already done that, by proposing a change at the top of that attempted to put text prominently at the start of a section, text that summarizes policy text that Paul gene wants to insert. This is indeed a small change: it's only 14 words, namely "Choosing among sources involves common sense, editorial judgment, and discussion on article talk pages." Eubulides (talk) 20:36, 30 September 2008 (UTC)
 * Cool. I'll ask Paul about that. --Kim Bruning (talk) 20:38, 30 September 2008 (UTC)

Paul Gene's answers
(long by necessity as I tried to represent the points of views of all of the editors, and most of them are burned out)


 * My position:


 * 1  This page is not sufficiently developed to be a guideline and may actually be harmful in some aspects.(see two different views on how it is inadequate:  and ) Several editors mention that this page is good for helping new editors. The same editors appear to agree that for an experienced editor this page adds almost nothing to the existing guidelines. Helping newbies is a good reason to exist for an assay, but the guideline should also be useful for others.


 * 2   In particular, the definitions of primary and secondary sources are confusing.. They should be explained along the lines outlined by WhatIamdoing  : “Lab records=primary source for a given fact. Original paper reporting lab results=secondary source, but primary literature. Review paper (say, comparing half a dozen similar original papers)=tertiary source, but secondary literature.”


 * 3   Since primary literature in medicine is actually secondary sources, it is generally reliable, and appeals to WP:NOR and WP:V to support the exclusion of research papers are without merits. Moreover, the idea to exclude original research publications is contrary to the community practice. Most of the references for the WP:MED featured articles are to original research papers not to the reviews. The exclusion of research publications may help newbies but it will make the life of experts (such as myself) miserable. This deficiency of the current page has been discussed by multiple contributors over the years and the compromise has never been reached. See for example


 * 4 A procedural point, but only to answer the often raised argument that this page has been around for 22 months so it deserves to be a guideline. This page was set up as a proposed guideline 22 months(!) ago . Despite the continuous re-submission of this page as proposed guideline, the consensus could not have been reached for 22 months. According to normal WP process, it should have been labeled rejected or historical long time ago. Indeed it was labeled historical in January 2007 and reverted by Sandygeorgia. It was rejected in May 2007 (see   and  and related discussions). This rejection was reverted over the insistence by Sandygeorgia and Colin, who is the page owner. In June 2007 it was downgraded to just a project page  Any work on the page then essentially stopped till June 2008. The page was again restored as a proposed guideline in August 2008 by WhatIamdoing. Now the story is being repeated again.
 * The existence of this "walking dead" page itself is an abuse of Wikipedia process. This Frankenstein monster is killed and revived again, unchanged, and it just never dies. To remind all involved the relevant policy WP:PG: “A failed proposal is one for which consensus for acceptance has not developed after a reasonable time period. Consensus need not be fully opposed; if consensus is neutral or unclear on the issue and unlikely to improve, the proposal has likewise failed. It is considered bad form to hide this fact, e.g. by removing the tag. Making small changes will not change this fact, nor will repetitive arguments. Generally it is wiser to rewrite a failed proposal from scratch and start in a different direction.”


 * My compromise:


 * The opposed points of view on this page are - this is a rejected guideline vs. this is an accepted guideline. The compromise would be to return to the page's status as a project page. Then the disputed tags could be removed from the parts of this article. As a project page, this page would be still helpful for newbies while not hindering the work of experienced editors.


 * In this new project page we should insert the full quotation from WP:NOR to make it unbiased: “Appropriate sourcing can be a complicated issue, and these are general rules. Deciding whether primary or secondary sources are more suitable on any given occasion is a matter of common sense and good editorial judgment”t (see this discussion for the background: Wikipedia_talk:Reliable_sources_(medicine-related_articles)).


 * The topic of reliability of sources is covered rather well in WP:NOR, WP:V and WP:RS. The new proposed guideline could be started, though, devoted to the question of what sources are the most useful for medical articles. It could be called MED:Sources, and incorporate the practical advice from this page.


 * Others' positions:


 * Colin is happy with the current text and it meets his present understanding of medical sources, although it can be improved.


 * Eubulides thinks the page unquestionably meets the requirements for a guideline, although could be improved. He would defer to Colin who is “a topflight editor”. Eubulides would almost surely withdraw any proposal Colin disagrees with.


 * WhatIamdoing has “no interest in pushing cutting-edge research into Wikipedia. In fact, one of the goals of MEDRS's version of WP:PRIMARY is to keep unconfirmed, cutting-edge research out of Wikipedia by strongly preferring proper secondary literature (which takes months, if not years, to appear) to primary literature.”


 * Sandygeogia thinks that “in a content dispute, WP:V suffices to cover the content at MEDRS anyway, and the additional info there was only intended to provide specifics about medical sources. Whether the page is or isn't a guideline will not change good, policy-based editing on medical articles in practice; the absence of the page as a guideline will, however, make editing harder for new editors.”


 * Eversince – the page should not be a guideline because it will prevent the inclusion of the reputable views from the other fields (Philosophy, Psychology, History, Literature, etc) on medical topics. The current policies (WP:NOR, WP:V) are sufficient.


 * NBauman would like to see more nuance in the definition of the popular press coverage. The scientific evaluations of the accuracy of popular press should be used in the guidelines, not just simple assertions by the editors.


 * UnaSmith – this proposal is contrary to the intent of Wikipedia by being far too prescriptive, and trying to prescribe something which should be a matter of editorial judgment. For example, she has read far too many mediocre review articles that are a giant step backward from the original research literature they cite. In her opinion, this page is not an improvement on Reliable sources.


 * Mihai Cartoaje is concerned with the conflict of interest, which permeates the medical research. (IMHO a very valid point, see  )


 * Ludwigs2 – Although the news media can be wrong, it often “can and does present decent, effective, readable reports that can sometimes have distinct advantages over academic journal articles from the perspective of wikipedia”, for example, by being more readable and when medical researchers have a conflict of interest.


 * Others' compromises:


 * Colin can compromise on the addition of the caveat from WP:NOR. He would not compromise on the definition of Primary and Secondary sources as he believes that his understanding of the issue reflects WP policies.


 * Eubulides tried to unsuccessfully find a compromise with me on the inclusion of the caveat from WP:NOR (see Wikipedia_talk:Reliable_sources_(medicine-related_articles))

Paul Gene (talk) 14:50, 27 September 2008 (UTC)


 * Alright, can you point out some things that Eublides would like to change that you agree with (partially or entirely)? --Kim Bruning (talk) 19:03, 30 September 2008 (UTC)


 * Eublides proposes adding the words: ""Choosing among sources involves common sense, editorial judgment, and discussion on article talk pages.", which he thinks/hopes you'll agree with. Do you indeed agree with that? --Kim Bruning (talk) 20:39, 30 September 2008 (UTC)

Primary and secondary sources
Paul (above) states that the definition of primary and secondary sources in WP:MEDRS is confusing. Bearing in mind my amateur status and that I'm always willing to learn or be corrected, I think some recent comments have muddied the waters. I have done some research and can find no sources that backup the idea that lab books are the primary sources and published results are therefore secondary sources (primary literature). All my research concludes that both are primary sources but since the former is usually unpublished, it is irrelevant for WP purposes. Indeed, I've seen the words "sources" and "literature" used interchangeably. Here are some sources:
 * Evolution of Scientific Information - Primary sources - Secondary sources - Tertiary sources Timken Science Library; Guide to Library Research in Science.
 * Primary, Secondary & Tertiary Sources James Cook University; Library Guides.
 * primary source - secondary source ODLIS — Online Dictionary for Library and Information Science
 * Primary source - Wikipedia; The Free Encyclopaedia.
 * WP:NOR "Primary sources are ... written or recorded notes of laboratory and field research, experiments or observations, published experimental results by the person(s) actually involved in the research;" - Wikipedia; The Free Encyclopaedia.
 * Types of nursing information University of Connecticut; University Libraries.
 * Guidelines for Assessing Professional Information Washington State University; Department of Veterinary Clinical Sciences.
 * Primary, Secondary and Tertiary Sources in the Health Sciences (PDF) University of Minnesota; Bio-Medical Library.

If it helps, we can flesh out the PST definitions and cite some of the above sources to show this isn't just something we've made up. So, our definitions of PST are consistent with both the Wikipedia article, Wikipedia policy, and the use of the term by librarians and other researchers wrt scientific and medical sources. This makes Paul's point (3) (primary published research == secondary sources == preferred) fallacious and not worth pursuing.

I think the fundamental thing Paul is getting wrong is switching his mindset from writing a scientific review paper to writing a wikipedia article. This is made clear by his comment "Moreover, the idea to exclude original research publications is contrary to the community practice." Firstly, let's be clear that WP:MEDRS does not "exclude original research publications". Indeed it takes several sentences to explain that they can be used. This is why I am puzzled by the need for yet more guidance to use "common sense".

Community practice, when writing a review, is to invite or receive a paper by a recognised expert in the field. This is then peer-reviewed by other recognised experts in the field. It is then published by a journal that has editorial control over which articles are included or not, and recognises the permanence of what they say and the effect that may have on their reputation. Authors are encouraged to give credit to the source of any statements they make and so cite the original primary source of the information. Indeed, citing secondary sources is discouraged as laziness but may be done if the source is very old or in a foreign language. Citing a primary source having only read a secondary source is very naughty.

None of this applies on Wikipedia (apart from the last bit, which is still naughty). Paul may, for all I know, have faked his user page and be a shelf-stacker at Tesco who dropped out of his pharmacy degree and is using his girlfriend's university library account to look up papers. As for Eubulides, who knows but he's probably not Eubulides, the philosopher. The result is that although expertise, education and experience are all immensely valuable on WP, they cannot be tested and so cannot be trusted and so don't matter one jot when it comes to WP:V/WP:NOR. summed this up nicely when he said, "Do not write your own comprehensive review of the [primary] scientific literature." (my insertion). I think that (or similar wording) should be added to the Nutshell of WP:MEDRS. It is vital to the mindset-shift that must occur when writing on WP. Expert editors must resist writing what they (or the colleagues they ask) know already and just find (primary) sources to back that up. And they must resist reading reviews and copying the primary sources from the review (naughty, naughty) as though they were writing their own review.

So, this is why citing primary research is so dangerous. POV pushers can search PubMed and find primary research to back up any point of view. Experts who fall into one school-of-thought can unbalance an article by citing primary research that favours their opinions. Editors who think they are experts, but haven't actually studied the subject since medical school 15 years ago, could find ancient primary sources to back up their out-of-date and rather rusty knowledge. Since nobody on WP is trusted as an expert, we must cite experts to give authority to what we say. It is all right for a real expert writing a review in the NEJM to cite a population study in Minnesota and claim this establishes the prevalence of some disease. A WP editor cannot do this and should cite an expert who reviews this study, evaluates it, generalises it, and gives it clinical significance.

Paul says "The exclusion of research publications may help newbies but it will make the life of experts (such as myself) miserable". I've noted the lack of "exclusion" in WP:MEDRS already. But I'm interested to know if/why your field is so void of literature and systematic reviews that can be trusted to summarise the current opinion of the field. Can you give some examples of text you'd like to add to WP that you would be unable to do without citing primary research? The only time I've felt the need to do this is where I'm giving extra detail on the research itself rather than on the findings. I've always been able to find secondary sources for such findings that matter to WP (unless the primary research is only months old, in which case it must be rather special). Colin°Talk 21:59, 27 September 2008 (UTC)


 * If you cite only the review, you quickly end up like a situation in Stroke, which shows how Jfdwollf did most of the expansion based on a single review. I do this myself too: however, when relevant, I also add useful primary sources, mainly to ensure that the key studies in the field are mentioned in the article (you know, JAMA, NEJM, Lancet and BMJ articles that any review on the matter would include). So yes, I I'm a fan of primary sources, but not to debunk the conclusions of reviews (unless they are very convincing and very recent). As a reader, I would appreciate the inclusion of the most important primary sources (things like the 4S study, for example), not just a review. So yes, I might be "reading reviews and copying the primary sources from the review (naughty, naughty) as though they were writing their own review". Look at the section Acne which I just rewrote. Would you really prefer to have me cite the same review 15 times instead of selectively using the same primary resources as the review did? --Steven Fruitsmaak (Reply) 22:13, 27 September 2008 (UTC)
 * Both Autism and Ketogenic diet show it can be done. In the latter, I can cite whole paragraphs to a relevant review. (I'm still working on that article; it is not a perfect example).
 * You are not a typical reader. You know, 99% of readers don't get past the lead section, never mind study the references. Correction, if you examine the stats, 99% of readers are still studying their naughty bits and working their way through List of sex positions. Anyway, how many readers really need the citation for the primary source? If the study really is seminal and of historical importance, you can mention it and cite it in the article: "A study in 2004citation to study found that xxx.citation to review" Or you can cite both with two separate footnotes or cite the review but mention in the footnotes that the review was, in turn, citing the primary research. All sorts of possibilities. But let's not confuse mentioning the primary study for reader education with citing the appropriate source for WP:V/WP:NOR. Colin°Talk 22:34, 27 September 2008 (UTC)
 * I agree that most readers don't look at the references, but those who do will be rather pleased with finding not only reviews, but on top of that, the leading studies. I'm rather opposed to mentioning studies in the text itself, unless they are truly monumental, and anyone should know their names (e.g. the 4S study or the Million Woman study). Does it matter that it was 2004 and it was published in JAMA? No. Does the primary study itself matter? Yes, and it should be cited, alongside with a review (exceptions notwithstanding, e.g. fastly evolving fields that haven't been reviewed yet, in which case editorials could provide context). My position is that reviews should be used to comply with WP:V, but significant primary research can be used for the interested reader (see for example, User_talk:Stevenfruitsmaak). --Steven Fruitsmaak (Reply) 23:00, 27 September 2008 (UTC)
 * Steven, it is a misconception that WP:V requires you to use reviews. Reviews not mentioned there even a single time. What it actually says is this: "In general, the most reliable sources are peer-reviewed journals and books published in university presses; usually followed by university-level textbooks; then by magazines, journals, and books published by respected publishing houses; then by mainstream newspapers. Special cases may arise; and editors should be careful not to exclude a point of view merely because it lacks academic credentials....Academic and peer-reviewed publications are highly valued and usually the most reliable sources in areas where they are available, such as history, medicine and science. Material from reliable non-academic sources may also be used in these areas, particularly if they are respected mainstream publications. The appropriateness of any source always depends on the context. Where there is disagreement between sources, their views should be clearly attributed in the text." I am sorry that you are trying to avoid using research papers because of this misconception. This is the situation I am trying to clarify. Colin's proposal would have me cite the paragraph above too often. Then I will have to add this: "Because policies take precedence over guidelines, in the case of an inconsistency between this page and that one, this page has priority, and WP:RS should be updated accordingly." Please note, here I am trying to defend WP policy vs a fringe group which does not reflect the opinion of the community. Paul Gene (talk) 00:49, 28 September 2008 (UTC)
 * Paul, Steven's need to cite reviews to be in compliance with WP:V will be because it is the reviews that he has read and form the source for his WP text. This is what WP:V requires: you cite your sources, not their sources. You know by now that it is WP:NOR that makes us cautious about citing primary research. And citing is quite different from mentioning (whether in the body or in the references). Colin°Talk 07:09, 28 September 2008 (UTC)


 * Colin, your definition of Primary and Secondary sources is confusing because it confused not only me but also WhatIamdoing and two other people (see diffs in point 2 of my reply). Paul Gene (talk) 00:52, 28 September 2008 (UTC) And my field is psychopharmacology where conflict of interest is rife.Paul Gene (talk)
 * If those folk can provide sources to back their definitions of PSTS, then we can have a discussion on how to resolve the confusion. Until then, I think I've provided ample evidence that the current definition is consistent and not confusing. Colin°Talk 07:09, 28 September 2008 (UTC)
 * The statement from the proposed guideline "Wikipedia's medical articles should be based upon published, reliable secondary sources whenever possible." with secondary sources defined as "reviews and guidelines" (important because this is a wrong definition) has no support in Wikipedia community practice. Featured articles are the best the community produces and thus are looked upon as the examples of the best community practice. Lets look at the featured articles from WP:MED project. Exhibit 1: Chagas disease. Out of 55 sources - 33 are original research papers, 17 are reviews and guidelines and 5 are others (editorials, press-releases, newspaper articles). Paul Gene (talk) 01:55, 28 September 2008 (UTC)
 * Exhibit 2: Keratoconus. Out of 64 sources - 38 are original research papers, 19 are reviews, guidelines and textbooks, and 7 are others. Paul Gene (talk) 02:30, 28 September 2008 (UTC)
 * I'll look at some FAs later. Remember that a primary source is likely to only verify a micro-fact within an article whereas a review can source a whole section. For the purposes of WP, reviews are information-dense and so you need less of them and need to cite them less often. Colin°Talk 07:09, 28 September 2008 (UTC)
 * My point is that your rule ("should use reviews when possible") has so many exceptions that it is not practical to follow it. It is plain "not possible" to use mostly reviews in FA articles. It places an onerous burden on their writers. Your rule would require constant explanations and referrals to WP:IAR from the writers of FA-class articles. Your rule would mislead newbies into deleting the references to the research articles and make the life of experts miserable. Paul Gene (talk) 12:49, 28 September 2008 (UTC)
 * It is not "my rule". And the guideline clearly says reviews are preferable but you can use primary research as sources "with care". You are reading restrictions where there are none. IAR doesn't need to be invoked. Only common sense (which doesn't need to be explicitly sanctioned; it is a guideline). Colin°Talk 14:42, 28 September 2008 (UTC)
 * My point is that the rule you are promoting ("should use reviews when possible") has so many exceptions that it is not practical to follow it. It is plain "not possible" to use mostly reviews in FA articles. Since the research articles are used so often in FA-quality articles the common sense requires us to ignore "should use reviews when possible". Paul Gene (talk) 17:47, 28 September 2008 (UTC)
 * Sure it's practical to follow it. If you have a reliable primary source and a reliable review on the same point, prefer the review. What's impractical about that? It's a simple guideline and works well in practice. Eubulides (talk) 04:51, 29 September 2008 (UTC)
 * WP:MED featured articles: Chagas disease. Out of 55 sources - 33 are original research papers, 17 are reviews and guidelines and 5 are others (editorials, press-releases, newspaper articles). Keratoconus. Out of 64 sources - 38 are original research papers, 19 are reviews, guidelines and textbooks, and 7 are others. Are you saying it is practical to follow the rule that has more exceptions than positive examples? My compromise: Define when it is practical to use reviews. For example, not practical - in the articles on narrow subjects such as Chagas disease, Keratoconus, bupropion, sertraline, etc. Practical - in the articles on the broad subject, such as major depression - I have advocated for that approach there - the research literature is too voluminous. Paul Gene (talk) 10:43, 29 September 2008 (UTC)
 * None of those numbers demonstrates that the rule "has more exceptions than positive examples". The rule is to prefer secondary sources when possible. Perhaps secondary sources were not available for the cases you mention. The current text already embodies the compromise that you seek: it says "when possible", and WP:MEDRS says "These guidelines are appropriate for actively-researched areas with many primary sources and several reviews, and may need to be relaxed in areas where little progress is being made and few reviews are being published." Eubulides (talk) 19:20, 29 September 2008 (UTC)
 * My view: If the guidelines are not appropriate for many FA articles they should be scrapped. They do not embody the best practice. My compromise: make them applicable by removing "should use secondary sources which are reviews and guidelines" and saying "use of reviews is encouraged particularly in the articles on the broad subject such as (example of FA article)." Paul Gene (talk) 09:31, 30 September 2008 (UTC)

Colin, I would prefer you quoted WP:PRIMARY specifically instead of WP:NOR in general, which confused me. Paul, I think Wikipedia clearly defines articles as primary sources and reviews as secondary sources. --Steven Fruitsmaak (Reply) 08:28, 28 September 2008 (UTC)
 * Steven, no it does not. The policy WP:PRIMARY defines primary articles as "Primary sources are sources very close to the origin of a particular topic or event[...] Other examples include... written or recorded notes of laboratory and field research, experiments or observations, published experimental results by the person(s) actually involved in the research" Most of the research papers in medical field are written by the principal investigator who is not "very close to the origin of an event" and who does not see the patients and only sees the notes by his assistants. Therefore, these are not primary but secondary sources.


 * Research articles based on drug trials are many degrees removed from the source. Drug trials are often done by outside contract research organizations, their results are then interpreted by the statisticians and principal investigator at the company, then written up by technical writers at the company, and then this ghost-written article is signed by a senior figure in the field who is posing as a principal author to add respectability. (See for example or look at the works of David Healy who wrote about the internal mechanics of the system.)


 * On the other hand, case studies are clearly primary sources by any definition, and so there is not disagreement that they are less reliable. Paul Gene (talk) 13:38, 28 September 2008 (UTC)
 * Paul, can you provide some reliable sources for your definition of PSTS. It disagrees completely with all of the sources above and you are misreading WP:PRIMARY. Your separation of investigator and assistant smacks of desperation. Colin°Talk 14:49, 28 September 2008 (UTC)
 * In the contemporary medical research the experiment and writing of the research paper are separated, often by multiple layers. It is a fact of life. There is nothing desperate in pointing that out. Your denial of this fact does not answer my argument.
 * The honest difference of views on the definition of primary and secondary sources in science, which you have with me and other editors (see and ) is the result of the difference of views in the literature. You cited the literature supporting your view. There are books supporting my and others' view:


 * Research Methodology by Ranjit Kumar: "The methods used to collect information about a situation, phenomenon, issue or group of people can be classified as: *primary sources *secondary sources. Interviewing, observation and the use of questionnaires are the three main methods classified under primary sources. All other sources, where the information required is already available, such as government publications, reports and previous research, are called secondary sources.”


 * Applied Science by Ken Gadd “Secondary sources. Often you will need to compare your results with those obtained by other scientists. This can be found in: databases, textbooks, data books, the scientific literature. An experiment used to obtain data is called a primary source. Sources of information that has been collected and recorded by other scientists, and recorded in a suitable form, are called secondary sources.”


 * Business Communication by Mary Ellen Guffey (this book uses the terms sources and data interchangeably): “Data falls into two broad categories, primary and secondary. Primary data result from firsthand experience and observation. Secondary data come from reading what others have experienced and observed. [Primary data] become secondary after they have been published.”


 * Choosing Research Methods by Brian Pratt and Peter Loizos “Existing sources of information sometimes called ‘secondary sources’, should always be checked before a commitment is made to new research and the collection of ‘primary research data’.” Paul Gene (talk) 21:00, 28 September 2008 (UTC)


 * Kumar gives as examples of secondary sources "office records" and "client records", suggesting that Kumar's definition of "secondary sources" is so far from Wikipedia's that it's not relevant here. Gadd's definition doesn't disagree with what's in WP:MEDRS. Guffey is about business communication, not biomedical research. Under Pratt & Loizos's definition, everything (including, say, your colleague's lab notebook) is a "secondary source", which means their definition has little to do with Wikipedia's as well. Eubulides (talk) 04:51, 29 September 2008 (UTC)


 * That is beside the point. Colin wanted independent sources that show the difference of opinions. I provided them. My compromise would be: leave the work on general definitions to WP:NOR and WP:V. Delete the definitions of primary and secondary sources from MEDRS. Instead concentrate on the real world situations. For example, reviews - for what type of articles they are the best? Research papers - when they better be avoided? Newspapers - when and how to use them? etc Paul Gene (talk) 10:28, 29 September 2008 (UTC)
 * It would be totally inappropriate to remove the useful elaboration of Wikipedia's definitions from WP:MEDRS, on the grounds that some other sources disagree with Wikipedia's definitions. It's not our job to override definitions from policy; it's our job to give guidelines explaining that policy as appropriate for medical articles. Eubulides (talk) 19:20, 29 September 2008 (UTC)
 * The reason to remove the primary vs. secondary definition because it is confusing and does not add any value. Focusing instead on the practical issues will make the guideline more useful. Paul Gene (talk) 09:44, 30 September 2008 (UTC)

Encourage use of reviews in WP articles
I just want to second the point that it's not the overall number of references that matter. It's how you use them. In User:Paul gene's examples, the reviews tend to be cited repeatedly -- up to nine times for a single source. The primary papers tend to be cited once. We want to educate inexperienced readers about the value of relying on reviews instead of trusting that this week's unconfirmed study won't be rejected next week. WhatamIdoing (talk) 01:25, 30 September 2008 (UTC)


 * Very good point. I update my calculations. WP:MED Featured article chagas disease refers to 17 reviews and guidelines that are cited 29 times. It refers to 33 original research articles that are cited 39 times. WP:MED Featured article keratoconus refers to 19 reviews, guidelines and textbooks that are cited 41 times. It refers to 33 original research articles that are cited 47 times.
 * My point: Why refer to a confusing concept of secondary sources to encourage the use of reviews? We can do this explicitly, but "should use" is too strong. My compromise: remove the paragraph repeating the primary/secondary definitions.  Start with "Basic advice". Move the paragraph "In general, Wikipedia's medical articles..." to "Basic advice" replacing "secondary sources" with "reviews and guidelines". Then we can discuss softening of the "should" later.Paul Gene (talk) 10:49, 30 September 2008 (UTC)
 * I see significant value in keeping those definitions. They educate the non-expert about how this specific recommendation coordinates with other Wikipedia advice.  WhatamIdoing (talk) 17:22, 30 September 2008 (UTC)

COI in secondary sources
Paul, you say "my field is psychopharmacology where conflict of interest is rife". I'm getting the impression that you are dismissing reviews in this field because the authors of those reviews have COIs and are biased. So rather than source our encyclopaedia on a review by an expert in a respected journal, peer reviewed by other experts, editorially oversighted, etc, you think it better if WP editors conduct their own balanced non-COI review of the primary literature. You may believe you are capable of doing such a thing, and may indeed succeed. But if you do, it will fail WP:NOR big time. Colin°Talk 08:51, 28 September 2008 (UTC)


 * It did not so far in the WP:MED featured articles bupropion and sertraline. I authored the most of these articles. Paul Gene (talk) 12:22, 28 September 2008 (UTC) I am not completely dismissing reviews in the area. But I take them with a huge grain of salt if they are written by the people from the company or sponsored by the company. (Checking the COI is really easy nowadays since most journals require the COI statement at the end of the article.) Such company-sponsored reviews very often misrepresent the findings of original studies in the light favorable to the drug/treatment or omit or dismiss the unfavorable studies. So, I check the actual findings of the research papers cited in a review vs. what they purport to say according to a review. If the review states one thing and the research paper - another thing, I would use a research paper. In such a case I closely hew to the interpretation spelled out in the original research paper to avoid OR. Here is where your preference of the reviews would be harmful and misleading. Paul Gene (talk) 13:09, 28 September 2008 (UTC)


 * Obviously some reviews are low quality, and they should not be used. However, as a general rule it's extremely unwise to rely on the interpretations of primary studies: in the vast majority of practical cases, they have axes to grind that are far sharper than the reviewers'. 04:51, 29 September 2008 (UTC)


 * The goal of writing a Featured Article or any article is to write a good article, not to write the article that follows all the rules (WP:IAR). If many reviews are of poor quality, as in my area, they should not be used. On the other hand, other areas of medicine have less COI and may have better quality reviews. My compromise: define such areas, include COI pointer. Paul Gene (talk) 10:55, 29 September 2008 (UTC)


 * This page should not get into the business of defining which medical areas are suspect. I doubt whether any such list could gain consensus. Eubulides (talk) 19:20, 29 September 2008 (UTC)
 * My compromise: to say "Be aware of possible conflicts of interests in some areas. Use conflict of interest statement usually appended to the article." Paul Gene (talk) 10:08, 30 September 2008 (UTC)

To the arbitrator of this discussion
← Let's all take a deep breath and step back. This ongoing argument is saddening, because I think everyone has the same goal: to write high-quality, accurate, and informative medical articles. I've seen both Paul and Colin do excellent work in this regard, and I know their hearts are in the right place. To me, the bottom line is that we're not sacrificing common sense or pretending that editors are mindless automatons. There is nothing in this guideline that prevents us from choosing and utilizing the best possible sources and accounting for COI and potential bias. If there is a real conflict in interpretation of primary studies, then we'll be able to find representative sources describing the various viewpoints. If every review, textbook, and position statement favors one interpretation, then we have to accept the possibility that regardless of COI's, that interpretation does represent expert opinion in the field. I think we can do this; I don't think anyone is going to run to the bupropion page and rewrite it based on industry-funded review articles. Let's look for common ground. MastCell Talk 17:11, 29 September 2008 (UTC)

In the mean time, I've posted my next question to Paul, Colin and Eublides. Anyone else who wants to participate in this systematic approach may do so, of course. :-) Is everyone fully aware of what I'm doing? Else I'll provide links or summaries for anyone who wants to join in.--Kim Bruning (talk) 19:08, 30 September 2008 (UTC)
 * I'm not. This page has a bad case of WP:TLDR (that can sometimes be an intentional tactic to stall debate), and I have no idea where to start.  A nutshell and some page archiving would help, but I suspect the verbosity will just fill up again.  Sandy Georgia  (Talk) 19:19, 30 September 2008 (UTC)
 * Totally with you on the TLDR :-P If we can summarize the debate, would you be willing to help me out on this? --Kim Bruning (talk) 19:53, 30 September 2008 (UTC)
 * Willing is not the same as able. I'm extremely busy, all the time, and I think Colin's links below sum up what's going on here. If there's a way to archive, start over and constrain the tendentious verbosity, I might be able to keep up and add something semi-intelligent.  Sandy Georgia  (Talk) 20:29, 30 September 2008 (UTC)
 * Cool :-) --Kim Bruning (talk) 20:43, 30 September 2008 (UTC)

A dead horse

 * WP:IDIDNTHEARTHAT
 * Righting great wrongs
 * WP:FANATIC
 * WP:DEADHORSE

Kim, I appreciate your, somewhat late, efforts to revive mediation. At present, I don't believe the project is best served by prolonging the above discussions. Wikipedia hasn't broken in the last month that this has been a guideline, though several editors have spent less time writing articles than they should. I propose this talk page be archived and that we refrain from discussing the above contentious issues for a period of time to allow freshness and a period of reflection. The above guideline/essay pages are my reasons why; interpret them to the above discussion/debate/argument as you see fit.

Colin°Talk 19:23, 30 September 2008 (UTC)
 * I don't know what people debated right above this section. I couldn't detect any system in it, so I skipped it. Is that ok? In the mean time, could you answer the question I left for you in the previous section we were working in ? That is systematic, and if there's any way to figure things out, that's where we need to work. --Kim Bruning (talk) 19:58, 30 September 2008 (UTC)


 * Although I have answered the question Kim Bruning left for me in, it appears that this mediation effort is more trouble than it's likely to be worth, and I agree with the suggestion to archive the talk page. Eubulides (talk) 20:19, 30 September 2008 (UTC)


 * I wouldn't know. The only mediation effort I'm doing is in the section on steps towards consensus. Anything else is random stuff other folks are posting that I'm not interfering with, and which I'm going to treat as irrelevant to that discussion. I've only really asked a couple of questions per person so far. If the random noise is distracting, I can move the mediation discussion to a more official medcab page, and/or I can silence this page (the latter is somewhat harder, because it might mean imposing things on people who aren't really interested in the discussion.) In the mean time, could I ask people who actually want to solve the situation to not start random chatter? Thanks :-) --Kim Bruning (talk) 20:27, 30 September 2008 (UTC)
 * Kim, mediation requires commitment; a four day absence suggests otherwise. I strongly re-iterate my advice that all parties in this discussion need to take a break from it. To answer your question above. Nope. Colin°Talk 22:08, 30 September 2008 (UTC)
 * and this is the way an essay gets edit-warred into being a guideline. fabulous...  no worries, though - I intend to to wp:IAR wherever necessary, and I suggest others do likewise.  -- Ludwigs 2  22:32, 30 September 2008 (UTC)
 * Since this page reflects WP:V policy, I wouldn't advise IARing it; your mileage may vary, but I like my clean block log. (Besides, it sounds like you may not understand the distinction between a guideline page and policy page.)  Sandy Georgia  (Talk) 22:38, 30 September 2008 (UTC)
 * Colin: I'm quite committed to maintaining wikipedia, thank you, but it's something I do in my free time. I'm a volunteer, not an employee. There's no rush. The wiki won't go away while we're at work or tending to other commitments. This doesn't just go for me, it goes for others too. If you don't make the wiki the center of your life, wiki problems seem a lot less pressing, and you can look at them with calm detachment. :-) --Kim Bruning (talk) 22:56, 30 September 2008 (UTC)
 * I fully understand the volunteer aspect, and am not demanding anything from you. You are working with editors whose patience has worn thin, which is why a break (and perhaps a slower pace) is needed. An analogy: you told a bunch of noisy schoolboys to sit still and then left the classroom for an hour. Colin°Talk 06:47, 1 October 2008 (UTC)
 * Agree with Colin about leaving misbehaving schoolchildren. Agree with a break but on one condition. As a temporary, ugly and middle of the road compromise - add a rejected guideline banner to the page in addition to the guideline banner. If (scratch it) When we find a compromise on the important topics the rejected guideline banner can be removed. ;) Paul Gene (talk) 11:35, 1 October 2008 (UTC)
 * No. Colin°Talk 12:50, 1 October 2008 (UTC)

archiving
I'd like to archive most of the talk page. I think i have consensus for this, but I'm not yet 100% certain. Is anyone particularly *opposed* to archiving? If so, why? --Kim Bruning (talk) 20:45, 30 September 2008 (UTC) Don't bother to reply unless you're opposing please!
 * Not I. I will try my best to follow if we start over and stay on topic, but no promises.  Sandy Georgia  (Talk) 20:46, 30 September 2008 (UTC)
 * Might I suggest a topic archive to keep regular archive an easier read? LeeVJ (talk) 20:54, 30 September 2008 (UTC)
 * Isn't that going to be a lot of work? --Kim Bruning (talk) 21:15, 30 September 2008 (UTC)
 * On reflection - the debates are rather 'intermingled' so scratch that... personally would welcome a more structured debate, sticking to each point in turn, with less deviation. Editors have put vast amounts of effort into this, and this has led to finely honed arguments which I feel could be stated in a clearer way than the historical talk shows. LeeVJ (talk) 21:40, 30 September 2008 (UTC)

I'd say archive the whole thing, including this section. Eubulides (talk) 06:21, 1 October 2008 (UTC)
 * And then let's follow that by a forced break for a few days. This page is exhaustively beating a dead horse. I've been trying to read over this discussion (which I can do when it's archived), and I'm seeing a lot of wikilawyering that creates a diversion from the fundamentals being discussed, misrepresentation (yes, I said this page mimics policy as it should and if editors try to use primary sources incorrectly, WP:V can deal with that, but no that doesn't mean the page shouldn't be a guideline, it's very helpful as a guideline page). The discussion may be more productive if reinitiated after a few days' break.  Sandy Georgia  (Talk) 07:05, 1 October 2008 (UTC)
 * Agree with Sandy about this supposed guideline being a dead horse. As I pointed out in my point 4 - this supposed guideline should have been dead long time ago. Unfortunately, it is not because of repeated efforts by Sandy to ram it through without sufficiently changing it. I also note Sandy's tendency to call "wikilawering" everything she does not like. Comments like that introduce discord and prevent the consensus from forming. Paul Gene (talk) 11:44, 1 October 2008 (UTC)

Steps towards consensus
suggested on Wikipedia talk:Consensus that those editors discussing contentious issues at WP:MEDRS answer four questions:
 * Your current position as to how MEDRS should be formulated (and reasoning why)
 * Some idea of where you're willing and able to compromise on that position.
 * Your current view/ best estimate of where each of the other participants stand, singly and as a group (and reasoning why).
 * Your current best estimate of where other participants are willing to compromise.

The idea hasn't been followed-through but may be worth exploring. Colin°Talk 12:38, 25 September 2008 (UTC)

Colin's answers

 * My position:


 * MEDRS should be in agreement with WP:PRIMARY in regarding secondary sources as the foundation of an article, and to use primary sources only with care. This policy is manifest in this guideline where we prefer to cite literature or systematic reviews rather than research papers. I note that some people have commented that there is a different definition of "primary source" within science (logbooks and database records); I'm using the definition on WP which is concerned solely with published material.
 * MEDRS should be in agreement with WP:V, which places peer-reviewed journals and academic books at the top of the quality tree, and mainstream newspapers at the bottom. ("In general, the most reliable sources are peer-reviewed journals and books published in university presses; usually followed by university-level textbooks; then by magazines, journals, and books published by respected publishing houses; then by mainstream newspapers."). WP:RS (or its example page) have long said that "popular newspaper and magazine sources are generally not reliable sources for science and medicine articles".
 * MEDRS does not need to spell out where editors should use common sense, judgement or talk pages. We have WP:IAR and other editor-behaviour guidelines for that. The whole guideline should be read in the context that it is merely a guideline, and is a part of a set of guidelines and policies that work as a whole. Colin°Talk 12:38, 25 September 2008 (UTC)
 * The use of reviews (expert opinion and analysis of the primary literature) enables editors to write better and more encyclopaedic articles. Both experts and POV pushers tend to write articles that mention study after study (the former because that's the style they read in the science journals, the latter because one can find a study somewhere to backup almost any claim). Mention of a study may be interesting and it may be necessary to constrain our certainty of the facts, but by-and-large an encyclopaedia should assert facts, not prove them. Colin°Talk 22:05, 1 October 2008 (UTC)


 * My compromise:


 * I'm not sure how the core of the first two points can be changed without bringing MEDRS into conflict with policy. A few editors have expressed support for the New York Times but since I don't read it, I can't judge. I don't believe any British newspaper has shown itself capable of reporting medical information reliably. Even if judged reliable, other aspects of a newspaper article make it a poor choice for anything but the most trivial medical fact. The exact wording used to express these guidelines is, of course, open to discussion. The third point can be compromised if there is consensus that MEDRS needs to spell out what some regard as obvious or repetitive. Colin°Talk 12:38, 25 September 2008 (UTC)


 * I'm less keen now, to accept the inclusion of the "common sense" clause immediately following the preference of reviews over primary studies. I believe it may be misused, cited and wikilawyered over. If challenged, editors should have a better reason for deviating from the general guideline than "I'm just using common sense" (the implication being the challenger is not being sensible). Colin°Talk 22:05, 1 October 2008 (UTC)


 * Others' position:


 * Paul regards the preference for reviews over original publications as "batty" because they are "written by the same people who do the original research, and they are subject to the same personal prejudices and biases". Therefore they should not be favoured. In addition, he would like the choice of secondary vs primary to emphasise the need for common sense, editorial judgement and discussion on talk pages.


 * Nbauman objected to how newspapers were regarded, though did not participate in the poll. Some effort was made to find a compromise wording that would be acceptable. A debate ensued where Nbauman believed this guideline's statements needed to be sourced per WP:V rather than be the collective opinion of WP editors. It was established that this requirement does not exist, but even if it did, sources could be found to support the idea that newspapers are not a good choice for medical facts. A compromise was reached with Nbauman where this statement was explicitly sourced in the guideline, even though such sourcing is not required. Ludwigs2 was another editor who objected to the anti-newspaper stance. Colin°Talk 12:38, 25 September 2008 (UTC)


 * Mattisse has contributed opinions based on his experiences and we seem to be in agreement. Colin°Talk 22:05, 1 October 2008 (UTC)


 * Others' compromises:


 * Paul has suggested (on my talk page) highlighting the danger in using reviews written by authors with a COI over the original research they are citing. I responded that this sounds like a valid concern, but very difficult to detect or enforce, and only necessary where the subject is controversial. Perhaps this idea can be explored by other editors. I have encouraged Paul to make this suggestion to a wider audience; he has not done so yet.


 * I get the impression that most examples given for valid use of newspapers involve some kind of scandal (e.g., Vioxx). Newspaper journalists can do investigative reporting, and medical journals generally do not. Perhaps those editors would be happier if the scope of "avoid newspapers" was clarified and restricted. For example, there seems little problem citing newspapers for historical events, current affairs, social and political issues (e.g., that a drug isn't available on the NHS due to a ruling by NICE), etc.

Please add your own subsection and we can then discuss the opportunities for compromise or changing-of-minds that arise. Colin°Talk 12:38, 25 September 2008 (UTC)

Excellent. Could Paul, Ludwigs2 and WhatamIdoing also reply? (Eusebus, Nbauman and others who would also like to post a similar text may do so too of course, it's still a wiki ;-). Don't worry if your version is substantially shorter or longer than Colin's version. As long as each of the 4 key questions are answered as best you can.) --Kim Bruning (talk) 16:45, 25 September 2008 (UTC)

Colin: your answer to 1 lists requirements, but I'm not sure what to do with them. Can you explain what you would like to change about the page right now? --Kim Bruning (talk) 21:30, 25 September 2008 (UTC)
 * I'm happy with the current text and it meets those requirements and my present understanding of medical sources. That doesn't mean I'm not open to being educated further or that I think the text is perfect. Colin°Talk 21:39, 25 September 2008 (UTC)
 * Ok, noted! :-) --Kim Bruning (talk) 22:40, 25 September 2008 (UTC)
 * Right. If Eubulides made the changes he proposes below, which of those changes would you *not* agree with, and why? Would you update your answers to the questions (especially 3 and 4) based on the data from Eublides? --Kim Bruning (talk) 21:23, 26 September 2008 (UTC)
 * Kim, the idea that you're trying to mediate between me and Eubulides is really funny. Colin°Talk 21:40, 26 September 2008 (UTC)
 * Meh, there's discrepancies between his position and yours right now. If you agree with his position entirely, that's fine, and all I need to know. :) --Kim Bruning (talk) 22:05, 26 September 2008 (UTC)
 * You said you'd support improvements. :-) Are some of the changes that Paul Gene proposes actual improvements? If so, can you specify which? --Kim Bruning (talk) 19:05, 30 September 2008 (UTC)
 * No. Nothing Paul has suggested here improves the guideline. Colin°Talk 17:36, 1 October 2008 (UTC)

Eubulides' answers
Eubulides (talk) 17:12, 25 September 2008 (UTC)
 * 1) MEDRS should supplement WP:RS, WP:OR, and WP:V with advice specific to biomedical articles, advice that is in agreement with the mainstream scientific consensus on medicine and biology. MEDRS should not unduly repeat the policy pages, nor restrict itself to merely saying what the policy pages say. Nor should it emphasize parts of the policy that we like and deemphasize the parts we don't like.
 * 2) It's OK to have brief summaries of what the policy pages say, to establish context.
 * 3) There are two overlapping sets of disagreements. One set disagrees with the current standing of newspapers in WP:MEDRS, and would like newspapers to be viewed more highly as a source. Another set disagrees with WP:MEDRS's strong position on favoring secondary over primary sources.
 * 4) above explores one way to compromise over the secondary-versus-primary dispute, by briefly summarizing the policy page in question. It's possible a compromise may be found there. For newspapers, it may be helpful to give another example or two where citing newspapers is OK.
 * Ok, also wondering about your #1, which changes should be made to the current page to meet your requirements? (answers to all 4 questions should be about concrete actions, but let's start at #1). --Kim Bruning (talk) 21:32, 25 September 2008 (UTC)
 * For #1, it's not so much a question of meeting requirements, as it is of improving the article so that it's more useful, particularly to editors new to Wikipedia's medical articles. Here are a few suggestions off the top of my head:
 * Remove the dispute tags.
 * Give advice that's specific to the section of the medical article. Sources for an Epidemiology section will have different characteristics than sources for a Classification section.
 * Give more examples.
 * Make the section headers shorter. Use fewer section headers.
 * Article type is out of place; it should be combined with the secondary sources bullet of Definitions somehow.
 * Periodicals, Books, and Online should be combined into a single top-level section, with duplicative material removed. Almost everything's online now, for starters.
 * Assess the quality of evidence available contains too much detail about evidence ranking schemes. It should summarize the point and give pointers to the details.
 * Eubulides (talk) 23:30, 25 September 2008 (UTC)
 * Ok, compare what you've written with the objectives written by Colin above (answers 1 and 2). Do you foresee Colin objecting to any of your changes? If so, why, and where do you believe you can reach a compromise? --Kim Bruning (talk) 21:25, 26 September 2008 (UTC)
 * Colin might object to some of those proposals; if so, I'd almost surely withdraw them, as Colin has more experience in this area and is a topflight editor. But I must say that it sounds like there's some confusion here, as Colin and I weren't disagreeing with each other. We were disagreeing with other editors, notably with User:Paul gene. Eubulides (talk) 21:39, 26 September 2008 (UTC)
 * Sure, noted. I guess you can tell I'm a neutral outsider here, since I'm just doing this systematically :-) --Kim Bruning (talk) 22:07, 26 September 2008 (UTC)


 * Alright, Paul Gene has pointed out his views now. Can you point out which changes that he proposes that you agree with? --Kim Bruning (talk) 19:04, 30 September 2008 (UTC) hopefully there's at least 1 :-)
 * I don't agree with the changes Paul gene proposes. The "compromise" in is not a compromise: it simply restates Paul gene's position, which is to remove guideline status from this page. The "compromise" also restates Paul gene's position to duplicate large chunks of text from a policy page, even though this would introduce redundancy and makes this page unbalanced. Paul gene has proposed these two changes many times, without anything remotely approaching consensus. In, I attempted a compromise on the second issue, involving a WP:SUMMARY of the policy-page text, but so far this compromise has been rejected. Eubulides (talk) 20:13, 30 September 2008 (UTC)
 * Ok, noted. So there is no change proposed so far, (however small), that you agree with?
 * Alright. based on Pauls position, is there any (small) change you could propose that you could both agree on? --Kim Bruning (talk) 20:21, 30 September 2008 (UTC)
 * I have already done that, by proposing a change at the top of that attempted to put text prominently at the start of a section, text that summarizes policy text that Paul gene wants to insert. This is indeed a small change: it's only 14 words, namely "Choosing among sources involves common sense, editorial judgment, and discussion on article talk pages." Eubulides (talk) 20:36, 30 September 2008 (UTC)
 * Cool. I'll ask Paul about that. --Kim Bruning (talk) 20:38, 30 September 2008 (UTC)
 * I've got the following text back: "Sometimes choosing between reviews and original research papers is complicated and requires editorial judgment and discussion on article's talk pages." . Do you have any issues with this particular phrasing that would preclude placing it on the MEDRS page? Does it require further changes? --Kim Bruning (talk) 22:36, 2 October 2008 (UTC)

(outdent) That text wouldn't work as well, as it uses terms like "reviews" and "original research papers" before they are discussed. Furthermore, the "is complicated" and "requires" unduly scares the reader. We shouldn't start off the guideline with a sentence that puts off naive readers; we should start it off with a friendly sentence. How about the following rewording instead? "Editorial judgment and talk-page discussion can help when choosing sources." Eubulides (talk) 23:23, 2 October 2008 (UTC)
 * Ok, Well, let's see where that gets us. --Kim Bruning (talk) 16:05, 3 October 2008 (UTC)

Paul Gene's answers
(long by necessity as I tried to represent the points of views of all of the editors, and most of them are burned out)


 * My position:


 * 1  This page is not sufficiently developed to be a guideline and may actually be harmful in some aspects.(see two different views on how it is inadequate:  and ) Several editors mention that this page is good for helping new editors. The same editors appear to agree that for an experienced editor this page adds almost nothing to the existing guidelines. Helping newbies is a good reason to exist for an assay, but the guideline should also be useful for others.


 * 2   In particular, the definitions of primary and secondary sources are confusing.. They should be explained along the lines outlined by WhatIamdoing  : “Lab records=primary source for a given fact. Original paper reporting lab results=secondary source, but primary literature. Review paper (say, comparing half a dozen similar original papers)=tertiary source, but secondary literature.”


 * 3   Since primary literature in medicine is actually secondary sources, it is generally reliable, and appeals to WP:NOR and WP:V to support the exclusion of research papers are without merits. Moreover, the idea to exclude original research publications is contrary to the community practice. Most of the references for the WP:MED featured articles are to original research papers not to the reviews. The exclusion of research publications may help newbies but it will make the life of experts (such as myself) miserable. This deficiency of the current page has been discussed by multiple contributors over the years and the compromise has never been reached. See for example


 * 4 A procedural point, but only to answer the often raised argument that this page has been around for 22 months so it deserves to be a guideline. This page was set up as a proposed guideline 22 months(!) ago . Despite the continuous re-submission of this page as proposed guideline, the consensus could not have been reached for 22 months. According to normal WP process, it should have been labeled rejected or historical long time ago. Indeed it was labeled historical in January 2007 and reverted by Sandygeorgia. It was rejected in May 2007 (see   and  and related discussions). This rejection was reverted over the insistence by Sandygeorgia and Colin, who is the page owner. In June 2007 it was downgraded to just a project page  Any work on the page then essentially stopped till June 2008. The page was again restored as a proposed guideline in August 2008 by WhatIamdoing. Now the story is being repeated again.
 * The existence of this "walking dead" page itself is an abuse of Wikipedia process. This Frankenstein monster is killed and revived again, unchanged, and it just never dies. To remind all involved the relevant policy WP:PG: “A failed proposal is one for which consensus for acceptance has not developed after a reasonable time period. Consensus need not be fully opposed; if consensus is neutral or unclear on the issue and unlikely to improve, the proposal has likewise failed. It is considered bad form to hide this fact, e.g. by removing the tag. Making small changes will not change this fact, nor will repetitive arguments. Generally it is wiser to rewrite a failed proposal from scratch and start in a different direction.”


 * My compromise:


 * The opposed points of view on this page are - this is a rejected guideline vs. this is an accepted guideline. The compromise would be to return to the page's status as a project page. Then the disputed tags could be removed from the parts of this article. As a project page, this page would be still helpful for newbies while not hindering the work of experienced editors.


 * In this new project page we should insert the full quotation from WP:NOR to make it unbiased: “Appropriate sourcing can be a complicated issue, and these are general rules. Deciding whether primary or secondary sources are more suitable on any given occasion is a matter of common sense and good editorial judgment”t (see this discussion for the background: Wikipedia_talk:Reliable_sources_(medicine-related_articles)).


 * The topic of reliability of sources is covered rather well in WP:NOR, WP:V and WP:RS. The new proposed guideline could be started, though, devoted to the question of what sources are the most useful for medical articles. It could be called MED:Sources, and incorporate the practical advice from this page.


 * Others' positions:


 * Colin is happy with the current text and it meets his present understanding of medical sources, although it can be improved.


 * Eubulides thinks the page unquestionably meets the requirements for a guideline, although could be improved. He would defer to Colin who is “a topflight editor”. Eubulides would almost surely withdraw any proposal Colin disagrees with.


 * WhatIamdoing has “no interest in pushing cutting-edge research into Wikipedia. In fact, one of the goals of MEDRS's version of WP:PRIMARY is to keep unconfirmed, cutting-edge research out of Wikipedia by strongly preferring proper secondary literature (which takes months, if not years, to appear) to primary literature.”


 * Sandygeogia thinks that “in a content dispute, WP:V suffices to cover the content at MEDRS anyway, and the additional info there was only intended to provide specifics about medical sources. Whether the page is or isn't a guideline will not change good, policy-based editing on medical articles in practice; the absence of the page as a guideline will, however, make editing harder for new editors.”


 * Eversince – the page should not be a guideline because it will prevent the inclusion of the reputable views from the other fields (Philosophy, Psychology, History, Literature, etc) on medical topics. The current policies (WP:NOR, WP:V) are sufficient.


 * NBauman would like to see more nuance in the definition of the popular press coverage. The scientific evaluations of the accuracy of popular press should be used in the guidelines, not just simple assertions by the editors.


 * UnaSmith – this proposal is contrary to the intent of Wikipedia by being far too prescriptive, and trying to prescribe something which should be a matter of editorial judgment. For example, she has read far too many mediocre review articles that are a giant step backward from the original research literature they cite. In her opinion, this page is not an improvement on Reliable sources.


 * Mihai Cartoaje is concerned with the conflict of interest, which permeates the medical research. (IMHO a very valid point, see  )


 * Ludwigs2 – Although the news media can be wrong, it often “can and does present decent, effective, readable reports that can sometimes have distinct advantages over academic journal articles from the perspective of wikipedia”, for example, by being more readable and when medical researchers have a conflict of interest.


 * Others' compromises:


 * Colin can compromise on the addition of the caveat from WP:NOR. He would not compromise on the definition of Primary and Secondary sources as he believes that his understanding of the issue reflects WP policies.


 * Eubulides tried to unsuccessfully find a compromise with me on the inclusion of the caveat from WP:NOR (see Wikipedia_talk:Reliable_sources_(medicine-related_articles))

Paul Gene (talk) 14:50, 27 September 2008 (UTC)


 * Alright, can you point out some things that Eublides would like to change that you agree with (partially or entirely)? --Kim Bruning (talk) 19:03, 30 September 2008 (UTC)


 * Eublides proposes adding the words: ""Choosing among sources involves common sense, editorial judgment, and discussion on article talk pages.", which he thinks/hopes you'll agree with. Do you indeed agree with that? --Kim Bruning (talk) 20:39, 30 September 2008 (UTC)


 * I agree with this statement the same way agree with the statement "The Earth is round". The Eubulides proposal is a platitude, does not add anything to the article, and there is no need to include it. Why not address the controversy directly: "Sometimes choosing between reviews and original research papers is complicated and requires editorial judgment and discussion on article's talk pages." Paul Gene (talk) 07:53, 2 October 2008 (UTC)


 * The wording of this principle, isn't it a matter for the core policy document Reliable sources? EverSince (talk) 08:40, 2 October 2008 (UTC)
 * @Eversince: Basically. We can sync both documents, if you like. Incidentally, can you provide a reference for the term "core policy"? --Kim Bruning (talk) 22:34, 2 October 2008 (UTC)
 * Kim, what I meant really was Verifiability: "Wikipedia:Verifiability is one of Wikipedia's core content policies...these policies determine the type and quality of material that is acceptable in Wikipedia articles" and its reliable sources section feeds into Reliable sources of course. Don't know about sync'ing. EverSince (talk) 09:41, 3 October 2008 (UTC)


 * @Paul Gene. I take it that's a yes then. Would you actually be opposed to putting Eublides' wording on the MEDRS page? In the mean time, let me approach Eublides. --Kim Bruning (talk) 22:34, 2 October 2008 (UTC)
 * Yes, he can put that wording on the page, and 2+2=4, too. Unfortunately, that does not solve the problem. Paul Gene (talk) 12:38, 3 October 2008 (UTC)
 * I got back "Editorial judgment and talk-page discussion can help when choosing sources." . Is that any good? --Kim Bruning (talk) 16:07, 3 October 2008 (UTC) (Ok, this is a tad slow... I'm going to actually turn on my brain now. O:-) )
 * This wording is the same as 2+1=3. Let me outline the problem as I see it. Contrary to the WP:PG policy, the proposed guideline does not reflect the best community practice in writing medical articles. The best community practice is embodied in WP:MED Featured Articles. It is to use reviews and original research papers in approximately equal numbers. Examples: Chagas disease refers to 17 reviews and guidelines that are cited 29 times. It refers to 33 original research articles that are cited 39 times. Keratoconus refers to 19 reviews, guidelines and textbooks that are cited 41 times. It refers to 33 original research articles that are cited 47 times.Paul Gene (talk) 20:40, 3 October 2008 (UTC) (Ok, trying to move gears a bit. Feel free to tell me that I overstepped and I will scratch my reply.) )
 * These numbers do not contradict the WP:MEDRS guidelines. WP:MEDRS says "medical articles should be based upon published, reliable secondary sources whenever possible" (my emphasis). Perhaps it wasn't possible in the cited articles.
 * The cited articles are reasonably old. Chagas disease became featured in July 2005, and Keratoconus in March 2006. Both these dates are before the first version of WP:MEDRS. It's not clear these older articles would still pass; FA standards have gone up since then. WP:MEDRS attempts to document current guidelines, not past guidelines.
 * Eubulides (talk) 23:08, 3 October 2008 (UTC)
 * Eublides: "medical articles should be based on secondary sources" is confusing to me. Can you clarify for me: does it mean the wikipedia definition of secondary source, or do you mean the biomedical definition of secondary article? --Kim Bruning (talk) 23:13, 3 October 2008 (UTC)
 * It means the definition of secondary sources given in WP:MEDRS, the section that contains the sentence "In general, Wikipedia's medical articles should be based upon published, reliable secondary sources whenever possible." that I was referring to above. Eubulides (talk) 23:18, 3 October 2008 (UTC)
 * %-/ No wonder there's confusion on that front! This is yet another, 3rd set of definitions. On the plus side, that explains a lot to me! :-) --Kim Bruning (talk) 23:28, 3 October 2008 (UTC) And it even links to PSTS, just to add to the confusion! 
 * Ok, having grabbed a cup of tea and thinking about it: Is it a consequence of the current wording that we should be avoiding the majority of texts published on pubmed ? --Kim Bruning (talk) 23:37, 3 October 2008 (UTC)
 * After some toast and some more reading, the wording appears to be VERY careful on this point, apparently some negotiation already happened there. I'm going to think about this and ask some more questions in the morning I think. (feel free to answer the question about avoiding pubmed though) --Kim Bruning (talk) 23:42, 3 October 2008 (UTC)
 * It's hard to say, but I'd guess that more than half of Pubmed should be avoided for medical articles. That is because more than half of Pubmed is over 10 years old, and older sources are likely supplanted by newer and more-reliable sources. Of course there are exceptions; please see WP:MEDRS for details. And again, this is just a guess. Eubulides (talk) 00:56, 4 October 2008 (UTC)
 * Importantly, it's not just the source. No source is universally reliable.  No source is universally appropriate.  Whether a source is appropriate or reliable depends very much on how the source is used.  Primary sources should not form the basis of the article.  That's why MEDRS says that "medical articles should be based upon secondary sources", not "medical articles should only cite secondary sources".  WhatamIdoing (talk) 01:10, 4 October 2008 (UTC)
 * Cool! WhatIamdoing, you may have found the source of the confusion. Some people may understand "should be based upon secondary" as "should always cite secondary". Let me see if I interpret you correctly. You are saying that reviews and textbooks do not have to be the numerically main part of the article, rather they should lay the groundwork or form the framework for it. That is something we could agree on. StevenFruitsmaak also expressed a similar sentiment here Paul Gene (talk) 03:20, 4 October 2008 (UTC) Jumping up and down at the chance to have a meaningful agreement.
 * Yes, goodness me! The reason why PSTS is discussed at NOR is because it concerns how you use a source. If it mattered to whether you can use a source, it would be at WP:V. Nobody is banning primary sources. One reason we prefer reviews is because you can say more (with confidence, without OR, and having some assurance of WP:WEIGHT). Sure, for the details (especially if one needs to discuss the details of studies) the primary literature may be required. There are also allowances in this guideline for when the secondary literature isn't substantial enough to build on. So, yes, the groundwork and framework, the major points/facts and the contentious facts. This is how I worked on the ketogenic diet: it was written from a handful of reviews and then fleshed out with a mix of reviews and primary studies. I recently analysed the text and 76% of the words are based on secondary sources. The 24% is mostly uncontentious supplementary detail. I would have thought a big subject like epilepsy could easily be 100% sourced to secondary sources. On other articles, the figures may be much, much less. Colin°Talk 08:32, 4 October 2008 (UTC)
 * Kim, in the archive you will find a list of online sources that define PSTS for science and medicine. I haven't found support for "the biomedical definition" you mention. Colin°Talk 08:32, 4 October 2008 (UTC)
 * Drat. I had some sources lined up... but... no mind for now though, as it'd just get in the way of your conversation with Paul. I'll reserve the option to come back to this topic later in case things somehow get stuck, but I'm entertaining the hope that that won't be necessary at all! :-). --Kim Bruning (talk) 03:14, 5 October 2008 (UTC) (Turning brain back off)


 * Yes, Paul, you seem to understand. Perhaps you now also understand why so many of us were confused by your opposition.  WhatamIdoing (talk) 16:44, 4 October 2008 (UTC) (who promises that if she ever intends for a guideline to require that something "always and only" be done in a single way, then the guideline will say so with an absolutely unambiguous phrase, like "always and only")

(undent) Would this wording be acceptable? Removal of the current wording is shown as the strike through. New wording is italics. - " In general, Wikipedia's medical articles should be based upon published, reliable secondary sources whenever possible. The best practice is to use reliable secondary sources, such as reviews and textbooks, to form the framework of the medical article. This framework can then be fleshed out by adding information from reliable primary sources, such as research articles. Reliable primary sources can add greatly to a medical article, but must be used with care because of the potential for misuse. Use primary sources with care to avoid engaging into original research. For that reason, e Edits that rely on primary sources should only make descriptive claims that can be checked by anyone without specialist knowledge." etc Paul Gene (talk) 19:23, 4 October 2008 (UTC)
 * I'm so glad we're no longer fighting over the definition of secondary. We say "based upon"; NOR says "rely mainly on"; neither say "always cited to", but I do feel it is more than just a "framework", which makes it sound like a review might do little more than supply the section headings (rather than be the foundation or even the main building blocks). Plus it seems to actually advise that the fleshing out be with primary sources. And the "use with care because of the potential for misuse" is a very important statement I'm reluctant to lose. Original research is not the only danger; WP:NPOV is hard to get right without consulting/citing the opinion of experts, which is where secondary sources come in. I am a little frustrated that we've wasted a month partly because "based upon" was misinterpreted, but it is a carefully chosen phrase. But to avoid accusations of WP:OWN, I'm not killing your suggestion and am open to other opinions and, of course, other suggestions.


 * Paul, I'm interested to know if you can "live with" the current text, and interpret "based upon" to whatever extent you feel comfortable with (saying yes, doesn't diminish your argument that your proposed text is better). You see, if we know you are no longer at war with the guideline, it will help us all relax and take our time over polishing the text. Colin°Talk 20:33, 4 October 2008 (UTC)


 * Hmm. I'm considering your "best practice" statement. I think there is value in describing an approach to article building that describes using core secondary sources as a foundation and adding a mix of primary and secondary material to flesh it out. Maybe this could go under "Basic advice". Perhaps we need input from a variety of our best editors to see how they've gone about the process. Then we can document the collective wisdom. Colin°Talk 20:44, 4 October 2008 (UTC)


 * Excellent! --Kim Bruning (talk) 03:14, 5 October 2008 (UTC)


 * I note that a subsection on NOR was recently created within WP:Reliable Sources, linking to No original research. And in it the phrase about secondary sources has become "based around", and the phrase about primary sources become "with extreme caution", while the relevant policy WP:NOR still says "with care" (as currently does MEDRS).
 * Can I also just note that MEDRS leads with "These guidelines supplement the general guidelines at Reliable sources", but in fact (and as per above discussion) seems to also be about supplementing No Original Research and Neutral Point of View. And supplementing seems to involve rewording. EverSince (talk) 09:54, 5 October 2008 (UTC)


 * Colin, what do you propose to fix the ambiguous wording of the paragraph in question? And why cannot we refer to best actual practice in the beginning? It is not a legal document we are writing, where all the definitions should be verbatim or very close to some official statute, but a helpful guide. Paul Gene (talk) 11:56, 5 October 2008 (UTC)
 * I think it may be worth starting a new section (if that's allowed, Kim) because these proposals are getting lost in among the position-statements of each participant. You can open it with e.g. "I found the following passage ambiguous ... and propose this replacement". If you want, I'll wait for others to comment/refine rather than put my views in first. I didn't find it ambiguous and think it provides enough wiggle room. Eubulides is pretty good with words, perhaps he can come up with something.
 * Wrt documenting best practice vs giving rules and guidelines: I think we need both. Sometimes when you just describe "how we do it", people find it hard to apply that to their situation. If first, you outline the principles you are working to, and then describe how we do it, they can come up with their own variation that still obeys the principles. Also, before describing a "do this then this" approach, I'd like to know if that's how people work or have found effective. What I'm trying to say is I'd like to get other input rather than play prose-tennis with you until we're happy but everybody else feels left out. Colin°Talk 13:04, 5 October 2008 (UTC)
 * If you both promise to proceed carefully, we could actually unprotect the page and try things out directly (possibly we could agree to let Eubulides do the typing for now? :-) ). If you're not entirely sure, or would like to discuss at the same time, feel free to open a new section; I propose we set the condition that every post in that section must suggest an edit for Eublides to carry out. A post in that section may discuss anything else too, including the weather in far off places, but must also include at least one instruction to Eubulides as well, however trivial. (if Eubulides thinks that this would be a fun and interesting thing for him/her to do? ) I have no problem solving the issues between Colin and Paul first. Often I first make a consensus of two, then add in number three, then four, etc... one at a time. --Kim Bruning (talk) 17:07, 5 October 2008 (UTC) The condition is designed so that each participant must propose progress of some sort, no matter what else they would like to discuss. Besides, discussing with restrictions is interesting. @Paul: Obviously I'll be monitoring such a section, so feel free to post there. :-)
 * Hmm. I was kind of hoping to tap Eubulides' brain for some suggested phrasings, rather than demote him to typist. Regardless of who the typist is, are you saying that each time we propose something, the page changes? Or only if we're both happy? What if Eubulides can, if he wants, suggest things to Paul and me, but then one of us has to propose it back (or similar) before it goes? Colin°Talk 17:52, 5 October 2008 (UTC)


 * A procedure that I've found helpful is that someone thinks out loud about what changes should be made; for example, I did this in above. Then someone (maybe the same person) builds on that to propose a specific change (down to each word that would be changed); I did this in  below. Then, this gets discussed and the proposal gets modified as discussion goes on. Then, assuming there's consensus, the change gets installed. In such cases, it's often helpful for one editor to do all the typing for the particular proposal (usually it's the editor that made the specific proposal). Obviously any changes that get installed should reflect overall consensus; it wouldn't suffice to get agreement only among Colin, Paul gene, and me. Eubulides (talk) 21:27, 5 October 2008 (UTC)
 * Hmm... In 1988 I'd have agreed. In 1998 I didn't know better. It's now 2008, and we have a new-fangled invention called a "wiki". I wonder if we can use it to our advantage? O:-)


 * I'll go talk with Paul first I think, to see what direction his thoughts are going. This discussion is furthest along, so I'll concentrate here first.
 * --Kim Bruning (talk) 18:24, 9 October 2008 (UTC)  You might think I'm being mildly sarcastic. Heck, even I thought I was being mildly sarcastic. But read back the talk page history for the past weeks. Has anyone actually mentioned trying to use the wiki to help solve the problems at hand in any way? But guess what... that's what a wiki is actually *for*. Let's see if I can show y'all, eh? :-) I may have some time this weekend I think (no promises yet, but I'll try!). 

Mattisse's answers
My position &mdash; Mattisse (Talk) 17:13, 1 October 2008 (UTC)
 * The New York Times is no more reliable than, for example, BBCNews in providing accurate, medical summaries of data. It should be used only in combination with other reliable sources of medical information to present the "popular press" view and never as a sole source of medical information.
 * Agree with WhatIamdoing on the issue of pushing cutting-edge research into Wikipedia. Specifically, in Psychology this is very risky as cutting-edge research can seem to support all sorts of "wacko" theories that are then presented as valid on Wikipedia.
 * The use of editorial "common sense" likewise is risky for the general editor writing in the field of Psychology. Witness the recent inclusion of Parapsychology by a sophisticated editor in the category  of Psychology in FAC. With expert writers, the use of "common sense" is somewhat  less risky although it is still subject to the bias of that expert editor. WP:IAR is used to cover a multitude of sins. Again, this is especially true in Psychology, where the misuse of sources is rampant, to the point that it is almost impossible to maintain a respectable article.
 * Agree that the use of primary sources should be undertaken only with great care and evaluation of the merits of the primary source. This includes primary sources in peer-reviewed journals also. Research articles are essentially OR, even if peer-reviewed since the researcher is reporting his observations (although a peer-reviewed journal is definitely superior to one that is not, as methodology is reviewed presumably). However, peer-reviewed journals contain articles on case studies, studies with low Ns, meta analyzes combining studies with widely varying methodologies, etc.  Also, witness a peer-reviewed journal of the American Psychological Association apologizing, because of public pressure, for a  research paper that was methodologically sound but had a politically-incorrect outcome. I strongly  support the preference for citing literature or systematic reviews rather than research papers.
 * I do not agree that WP:V and WP:NOR cover the sourcing problems that arise in medicine-related or science-related articles and that WP:MEDRS guideline is unneeded.  Evaluation of sourcing is more rigorous for these articles and the application of rules for establishing reliabilty are somewhat different.  Some of the information in WP:V, for example, can be seen as simplistic, misleading or inaccurate when used for this purpose.
 * Mattisse, thanks for joining the discussion. The above points look to be close to answering question 1 from Kim's four questions. Would you consider moving this section up to a sub-section of "Steps towards consensus"? It would also help if you could indicate what changes you would like to make to MEDRS. If you can answer questions 2-4 also, that would be great. Colin°Talk 17:24, 1 October 2008 (UTC)

The positions of others My compromises
 * I have no outstanding problem with the MEDRS guideline the way it is.
 * I am not opposed to having MEDRS  supplement WP:RS, WP:OR, and WP:V with advice specific to biomedical articles, as I do think the latter are misleading to the uninitiated editor which leads these editors to use inappropriate sourcing and therefore to (sometime wildly) inappropriate conclusions and even whole articles. In fact, I am inclined to support the primacy of MEDRS as a guideline for medicine-related articles.
 * I agree that the use of common sense does not need to be specifically addressed in the MEDRS guidelines. In fact, I do not think it should be.
 * I would be concerned about elevating the role of the popular press. As stated above, it can appropriately report on scandals and other issues not directly related to scientific evidence. Scientific American I would consider a tertiary source, useful for some purposes perhaps but not appropriate as a reference source to an article to support scientific findings.
 * I do not agree with the statement, "primary literature in medicine is actually secondary sources." I believe strongly in the distinction between the two, having seen misleading information in articles when this distinction is not observed.
 * I do not agree that the MEDRS page is not helpful to the experienced editor. I find it helpful and I consider myself experienced.
 * I do not agree with Paul gene's statements on the differentiation and ranking of sources nor on the usefulness of the MEDRS page, so I would have difficulty in agreeing to the demotion or mass altering of the page along the lines he seems to be suggesting.
 * I agree that MEDRS should be a guideline.

I would have difficulty greatly compromising my views regarding the MEDRS page, but I am willing to be open to the opinions of others if they present practical reasons for not agreeing with me. &mdash; Mattisse (Talk) 20:16, 1 October 2008 (UTC)


 * Ok, this actually looks like it might be useful as part of an answer to question 2. If you have time, could you research the positions of other parties in more depth, and provide answers to 3 and/or 4 as well? --Kim Bruning (talk) 16:18, 3 October 2008 (UTC)


 * Apparently you might have the same misunderstanding as Orangemarlin below? I'm actually asking what you know about other people's opinions, rather than your opinion on their opinions. :-) See my answer to Orangemarlin, and see if it helps you. If you're still confused, tap me on the shoulder! :-) --Kim Bruning (talk) 23:44, 3 October 2008 (UTC)


 * As explained below, I am unwilling to make further comments. Since my own simple question was completely misinterpreted and therefore provoked a negative reaction, I am totally unwilling to make comments or guesses about what I think other editors might think or do beyond what they have stated. I would base any conclusions on what they have said and nothing else. I am unwilling to hypothesize.  &mdash; Mattisse  (Talk) 00:59, 4 October 2008 (UTC)


 * Well, everything you do on wikipedia is by necessity going to be based on some underlying hypothesis as to the position of others/the community. As you yourself point out, it's very easy to make mistakes! I'd very much prefer for people to explicitly state their underlying hypotheses, so that we can all work together to systematically review and test them, and thus deduce a viable "theory of consensus" ;-) on this topic. This approach should yield the optimal course of action (or something close to it).


 * Occasional misunderstandings and problems are to be expected when you work like this. But with this approach, misunderstandings and negative reactions are not failures: they merely serve to disprove the working hypothesis. One can simply formulate a new hypothesis and try again.


 * If you don't quite feel up to doing that kind of thingxkcd quite yet, you can always choose to just answer questions I ask you in this section. I'll then talk with others and take the heat, if any is forthcoming. I have a similar arrangement with Paul Gene at the moment; he seems to be making progress! :-) --Kim Bruning (talk) 03:01, 5 October 2008 (UTC)


 * I do not mind disagreements. I dislike comments meant to intimidate my participation made with out even taking time to understand my question. My question was neutral. Mastcell choose to react negatively to me personally, making assumptions about my position,  without  addressing the question. If Mastcell is no longer a participant here, or if he is willing to cease making such responses, then I am willing to continue in the discussion.   &mdash; Mattisse  (Talk) 14:26, 5 October 2008 (UTC)

Jfdwolff's answers
My current position is that MEDRS was about to become an widely endorsed guideline if not for the vocal protests of two contributors. I am of the opinion that the last stable version should be kept at guideline status, as such a guideline was long overdue.

I am not willing to compromise on the basic tenets behind this guideline, namely that secondary sources are out of necessity to be preferred over primary sources. I have always held, however, that editorial judgment should be exercised when selecting secondary sources, and if a secondary source seems poor-quality, unreliable or biased there are usually alternative secondary sources to choose from.

I am not going to guess others' perspectives. We have heard enough. Neither am I going to speculate on their willingness to compromise. JFW | T@lk  22:11, 1 October 2008 (UTC)


 * Ok. However, if you wish to participate in a consensus process, or wish to form a consensus, you should nevertheless be taking those steps, be it implicitly or explicitly.


 * If you do not know your own aims, you can never reach consensus, because there is nothing to reach consensus over.
 * If you are unable to compromise, it is very hard to reach consensus, because you have no flexibility to negotiate with others.
 * If you are unaware of the aims of others, you can never reach consensus, because you have no information to build a consensus on.
 * If you are unable to gauge the ability of others to compromise, you are severely handicapped, because you cannot take advantage of the flexibility offered to you by others.


 * I'll gladly hear back from you anytime if/when you change your mind, and wish to participate in consensus formation. :-) --Kim Bruning (talk) 16:27, 3 October 2008 (UTC)

My brusque response above reflects my frustration with the fact that we cannot get this vital policy off the ground. Please bear with me.

You misunderstood my response in the sense that I know my aims very well: a working policy that gives primacy to reliable secondary sources for medical content. As this is basically a consequence of core Wikipedia policies such as NOR, V and CITE I don't think there's much to compromise over, because it is not mine to compromise (to paraphrase the late Lord Jakobovits). However, I can accept (and will concede) that newspaper articles are on rare occasions useful as secondary sources, but there needs to be clear consensus between an article's contributors that a particular newspaper article is a reliable source for the information quoted from it. Hence, in most situations I find newspaper articles unsatisfactory (e.g. see the recent fracas at number needed to treat over an article from Business Week that made possibly valid points but badly lacked context). Primary studies are occasionally good sources of information, especially where there are no comparable secondary sources (e.g. on central core disease), where secondary sources have not yet included the information in question, or where there is other information (e.g. from a major newspaper article) that suggests that a primary study has been disregarded in reviews. Editorial judgement trumps any policy, and requires consensus on a case-by-case basis.

I am only partially aware of the agendas of other editors, but I know that Paul gene wants greater liberty at citing primary studies because he feels they are selectively quoted or misrepresented in reviews written by drug company shills. This is an understandable frustration but borders on a stated intent to violate WP:NOR/WP:SYNTH, which I why I have opposed this. I am unsure if there is any strong desire to compromise from Paul or from other editors (such as ImperfectlyInformed) who have opposed this policy. JFW | T@lk  19:53, 4 October 2008 (UTC)


 * Cool! Thank you for taking the time to formulate such a well thought out answer.
 * I'm going to think about your answer for a bit. In the mean time, would you be willing to invite ImperfectlyInformed to try to answer the 4 questions too? I hope they might be able to provide some of the information you feel is missing. --Kim Bruning (talk) 04:22, 5 October 2008 (UTC)

All editors who have previously opposed this guideline presumably have this talkpage on their watchlist, and have now had ample time to offer their perspectives. If, on reviewing previous discussions, you feel that a particular editor is going to be of importance in achieving consensus you might wish to contact any such contributor yourself. I my mind, adding even more voices to this debate is going to increase noise and decrease the likelihood of any form of consensus emerging. JFW | T@lk  09:04, 5 October 2008 (UTC)

EverSince Comment
My feeling is that, rather than just an exposition of technical issues specific to medical sourcing, MEDRS is asserting reworded versions of core policies, in a way that reflects a point of view (medical or medical establishment) based on Ownership. Its basis in concepts of "medical articles" or "related to medicine" is problematic. I think there needs to be discussion somewhere of the need for guidance across different areas and how to develop and coordinate it in a way that doesn't potentially undermine NPOV. EverSince (talk) 07:33, 2 October 2008 (UTC)
 * Examples of rewording of core policies? Sandy Georgia  (Talk) 07:43, 2 October 2008 (UTC)
 * WP:NPOV mandates that we express ideas in proportion to their representation among experts in the field. You may, if you wish, refer to these experts as the "medical establishment". This project's fundamental goal is to create a serious, respectable reference work. This guideline is intended to give specific advice to implement those objectives on medical topics. I'm not seeing a problem. MastCell Talk 19:38, 2 October 2008 (UTC)
 * There is Scientific citation guidelines. Is this Ownership and undermine WP:NPOV? &mdash; Mattisse (Talk) 22:56, 2 October 2008 (UTC)
 * The scientific citation guideline addresses different issues. Obviously, I do not believe this guideline violates NPOV. Having re-read WP:OWN, I don't see what that policy has to do with this issue. MastCell Talk 17:19, 3 October 2008 (UTC)
 * I was merely making a somewhat frivolous reference to the comment of EverSince, pointing out that there are accepted guidelines for special areas other than MEDRS and that these are not considered to violate Ownership or undermine WP:NPOV. However, you are free to disagree with it if you like and to feel my comment was ridiculous and inappropriate if you like. &mdash; Mattisse  (Talk) 18:22, 3 October 2008 (UTC)
 * In fact, I am perfectly willing to withdraw from this discussion, if you like. &mdash; Mattisse  (Talk) 18:22, 3 October 2008 (UTC)
 * Ah, well, I misunderstood your comment. I'm sorry; it sounds like we're in agreement. Don't feel the need to leave on my account. MastCell Talk 18:43, 3 October 2008 (UTC)
 * :-) --Kim Bruning (talk) 19:54, 3 October 2008 (UTC)
 * I do feel the need to leave on MastCell's account. I'm unwilling to participate in a discussion where an editor's comment (or short question, in this case) about content is treated with ridicule and condescension by another editor who decides he does not like the point of view he thinks the question expresses. Mastcell's apology  is given only because he  decides he agrees with me after all. A discussion where I cannot ask a simple question without  being treated dismissively is not one where I feel comfortable in expressing myself further.  &mdash; Mattisse  (Talk) 00:42, 4 October 2008 (UTC)
 * I feel badly that you've taken offense; it was not my intention to be dismissive, but rather to concisely explain my opinion as it relates to the topic under discussion. MastCell Talk 06:30, 5 October 2008 (UTC)
 * Re. details of examples, think better to address in another section (if do at all). Re. NPOV, it doesn't say "experts in the field", but "reliable sources on the subject". It also says "A balanced selection of sources is also critical for producing articles with a neutral point of view.". Re. WP:SCICITE, I did previously wonder that, but ultimately it's much more narrowly framed, "about specific details of inline citation" to help editors on scientific projects. EverSince (talk) 22:51, 5 October 2008 (UTC)
 * EverSince, I know that you're heavily involved in anti-psychiatry issues, but even in psychiatry, most of the "reliable sources on the subject" have been written by the "experts in the field," particularly when we're talking about basic medical/scientific facts. WhatamIdoing (talk) 18:55, 6 October 2008 (UTC)

Ok noted for future reference. Eversince, If you'd like to have changes made to this page, please answer the 4 questions at the top of the talk page, and let's see what we can do. --Kim Bruning (talk) 16:16, 3 October 2008 (UTC)

The New York times has an article about how psychiatry articles are manipulated for political lobbying, with the publication of some results being delayed for years. A former president of the APA has admitted to political lobbying:
 * "That is something we have been trying to accomplish for at least 20 years. Finally! I hope the state will make good use of it.
 * Dan Bornstein
 * former president of APA"

Who is the "we" he is referring to? And how did they try to accomplish this? Was manipulating psychiatry articles and delaying the publication of some results for years part of this trying? --Mihai cartoaje (talk) 08:57, 10 October 2008 (UTC)


 * Mihai, in your view what constitutes a reliable source for a psychiatry article? The NY Times article you quote talks very peripherally about the issue. It seems to be more about how schizophrenia might be dementia praecox after all.
 * Similarly, the Bornstein quote is a short letter to the Treatment Advocacy Center newsletter, hardly a shocking source. What is your point? JFW | T@lk  13:01, 10 October 2008 (UTC)


 * Andreasen's reported statement seems ambiguous about how much she is attributing to the antipsychotic adverse effects. Having said that...

(deindent) ...I actually object to the original way in which my comment was derailed via an ad hominem non sequitur, distracting from my anti-domination-by-medicine points such as "A balanced selection of sources is also critical for producing articles with a neutral point of view." EverSince (talk) 11:19, 11 October 2008 (UTC)


 * You seemed to suggest that while in other fields, expert sources are favoured over non-expert sources, somehow medicine is different. Or did I misunderstand you? It would be helpful if you clarified your points, and if possible your underlying motivations. That would prevent your comment from being misunderstood or being used as a springboard for ad hominem comments. JFW | T@lk  19:56, 11 October 2008 (UTC)


 * I suggested it is MEDRS treating medicine differently, by only presenting selected aspects of policies & guidelines, and talking as if only medical experts and medical sources existed (while incidentally neglecting a plethora of other issues relevant to evaluating medical sources, including but not limited to the pharma conflict of interest that Paul Gene partially raised).
 * Your "underlying motivations" comment is itself an ad hominem, and I maintain my objection to the earlier one; and I now see another below about supposed underlying levels of interest (perhaps this is all being encouraged by Kim in the format of this mediation, I do'nt know). In fact the reason I've limited my comments here from teh start, and evidentally need to continue to do so (especially as other dissenters seem to have dropped out), is precisely because editors who express dissent here seem to end up having their comments used as springboards for ad hominems. As long as it seems more House Un-Medical Activities Committee than Principle of charity, there's no motivation for dissenters to participate (and I think it's a shame MastCell's and Mattisse's considered points below haven't been responseed to by any of those who might previously have). EverSince (talk) 18:51, 16 October 2008 (UTC)
 * EverSince, I don't think that having an underlying motivation for a suggested improvement can be considered an attack on you as a person. Your motivation could be a particular interest in a specific sub-field where the existing advice could be less helpful than it is for others (probably a motivation for Paul gene and Matisse).  Your motivation could be a current problem in a specific article (a common motivation for me).  Your motivation could be wanting MEDRS to avoid conflicts with other guidelines (a common motivation for Sandy).  Your motivation could be wanting MEDRS to be as little different from RS as possible.   There are many entirely laudable motivations; I am sorry that you assumed that all motivations must necessarily be nefarious, or at least suspect.  If you think your motivation is laudable, or at least legitimate, then please feel free to share it.  Perhaps that will help others understand your issues more clearly and be able to address them more fully.  WhatamIdoing (talk) 19:01, 16 October 2008 (UTC)
 * I never used the word "attack", I am well aware of what "motivation" can mean, and I didn't make any such assumptions. Your last suggestion is partially a repeat of Jfdwolff's suggestion that I start discussing my "motivation" (if I believe it is laudible or at least legitimate!) - but I already stated in response that I believe the personalization of this talk page has been detrimental to rational debate, and all I can do once again is object to this whole line of personalized inquisition. EverSince (talk) 20:48, 16 October 2008 (UTC)

SandyGeorgia comment
Because I haven't followed this page (which has enjoyed broad support for several years now) closely enough since it was elevated to a guideline, I can't speculate on the position of other editors or their willingness to compromise. I do know that only two vocal opponents have held up some elements of the page with ideas about sourcing that are at variance with WP:V.

I broadly agree with the answers from Colin, Eubulides, Jfdwolff and Mattisse, although I'm unaware of the "Common sense" compromise they reference. I would be wary of any relaxing of acceptance of primary sources and lesser quality sources than peer reviewed journals because they are the means by which fringe theories are inserted into medical articles, and any common sense compromise in that area would be susceptible to wikilawyering. Paul Gene's answers are too long to read: if a position on sourcing can't be summarized concisely, a position unsupported by Wiki policy may be present; Wiki policy is clear on primary and secondary sources, and delving into dictionaries for alternate definitions isn't relevant. I did note that he has somewhat misrepresented me twice on this page, and I see he neglected to mention that Una Smith opposes the guideline because she disagrees with other Wiki policy pages.

Most of the basics of this page aren't open to compromise without bringing them in to conflict with WP:V policy; the page is useful as a guideline to explain how policy is applied and interpreted in a specific group of articles. Secondary sources are preferable to primary sources, and that will prevail per policy, with or without this guideline.

On the newspaper issue, I have never, ever, once in 20 years of research, encountered a single newspaper or magazine account of Tourette syndrome that didn't have basic, fundamental errors. Here's a simple example from a 2005 article in The New York Times. No, GTS did not first describe TS in 1885; Itard did in 1825. This is the kind of inaccuracy one often finds in the laypress. And that's not even a medical fact; that's basic history, and the NYT didn't even get that right. They do worse on the medical; there are a few significant and numerous subtle medical inaccuracies in the article as well. (Side note, Eubulides, note the 750,000 children; I found this article just now on Google.) Even in the NYT, except for their quotes of Zinner, it's fluff at best, inaccurate at worst. Newspapers are not reliable for reporting medical information, but I agree with Eubulides that we could expand the examples of when newspaper, magazine and other sources can be used.

I apologize for not having followed closely, and that I can't add much more to the discussion, but I will try to stay better tuned in from here forward. Sandy Georgia (Talk) 09:19, 2 October 2008 (UTC)


 * Agree with the above. FYI, the "Common sense" compromise is at Wikipedia talk:Reliable sources (medicine-related articles)/Archive 2 . It proposed prepending "Choosing among sources involves common sense, editorial judgment, and discussion on article talk pages." to WP:MEDRS . Nobody else supported the compromise. Eubulides (talk) 17:58, 2 October 2008 (UTC)


 * Thank you. You sort of answer the 4 "question essential to consensus" that I posed, but the answers are intermingled. If at some point you find time to organize your thoughts further, that would be appreciated. :-)
 * It is to be understood that answers to question 3 and 4 will always contain inaccuracies. That's one of the reasons I'm asking for those answers explicitly, so that we can root out misconceptions between people. Can you point out where Paul Gene's perceptions need correction? Thank you so far for the information on Una Smith. I hope Una Smith shows up themselves, and provides more information on that. --Kim Bruning (talk) 16:12, 3 October 2008 (UTC)
 * Tourette syndrome is not a controversial topic. --Mihai cartoaje (talk) 08:59, 10 October 2008 (UTC)
 * Right. Gotcha.  Sandy Georgia  (Talk) 09:03, 10 October 2008 (UTC)

OrangeMarlin comments
I'm deeply troubled that we're engaging in this long discussion because two editors, one of whom has a long history of disrupting medical articles, have complained loudly about this guideline. Consensus does not mean two editors can stand in the way of progress. If this were true, the long history of any article in this project is doomed to failure. However, setting aside the personalities of two dissenters, details of my thinking are below:


 * My position:


 * 1) MEDRS should be in agreement with WP:VERIFY, WP:RS and WP:PRIMARY. Because medical articles must have a slightly higher standard than articles in other fields (using as an example, an article about recent politics), it should be clearly described.  In other words, as others have stated, this guideline is specific to medical articles, and sets standards, though based on other guidelines, has got to take it to another level.  When I write an article, I never use popular press (i.e., newspapers, magazines, etc) to support a statement.  When I see a popular press citation, I remove it and replace it with a peer reviewed article.  It takes very little time to do so.  The popular press, because it's journalism and not peer reviewed, has a tendency to position information to the requests of its readers, rather than to state what has been researched.
 * 2) I really have no concerns with the guideline as it is. It will useful in establishing what can be used as citations for articles.  I can't be happier, so that I quit seeing cruft being thrown into articles with the support being some off-hand statement in the New York Times.  Orange Marlin  Talk• Contributions 19:17, 2 October 2008 (UTC)


 * The positions of others:


 * 1) I disagree that this guideline is only useful to new editors. I completely disagree.  Not only will this be a good guideline for me when I'm unsure, but it can be used in content disputes in articles.
 * 2) I do not agree that this guideline is just a repeat of other guidelines that I've mentioned above. It's not.  It's an improvement specifically for medical articles.  For example, a New York Times article is fine for discussing Sarah Palin, but not very useful for Alzheimer's disease.
 * 3) I agree with SandyGeorgia's comments about newspaper articles. They're more often inaccurate rather than useful.
 * 4) I disagree with the comments about primary sources that are published in peer-reviewed journals as being the equivalent of secondary sources. In fact, some individuals use "letters to the editors", which are very primary sources, as citations, when they have no usefulness.  Secondary sources are the best.


 * Compromise


 * 1) None. Two editors complaining loudly is not a reason to have these issues with a guideline endorsed by a large number of editors.   Orange Marlin  Talk• Contributions 19:27, 2 October 2008 (UTC)


 * Ok, this answers question 1, and refutes the need for a question 2 (which is your prerogative) . Could you also answer questions 3 and 4? (to wit 3. what *are* the positions of others, as accurately as you can ascertain, and 4. where are others willing to compromise?) --Kim Bruning (talk) 16:30, 3 October 2008 (UTC)
 * Kim, I think I stated what I see as what others are saying. I happen to agree with the reasonable editors like Colin et al.  There are no compromises.  MEDRS should stay a guideline, and Paul should find another project for wasting people's time.   Orange Marlin  Talk• Contributions 17:45, 3 October 2008 (UTC)
 * Alright. Feel free to come back any time, when you are willing/able to answer the 4 questions as posed. --Kim Bruning (talk) 18:16, 3 October 2008 (UTC)
 * Dude, no need to be rude. I thought I had answered the four questions above.  I just thought 1&2 were combined, as you surmised.  My viewpoint of the positions of others is up there.  My compromise, which is NONE, is up there.  Not sure what you're asking, but either I'm totally misunderstanding you, or you're intentionally being a pain in my butt.   Orange Marlin  Talk• Contributions 19:59, 3 October 2008 (UTC)


 * Dude! I'm not trying to be a pain in your butt. Well... not too much of a pain in your butt. I'll assume you're doing the same.


 * I think see I the misunderstanding. You gave your opinions and views *about* the positions of others. However, those are based on a set of premises we haven't quite checked yet, which is whether everyone actually understands *what* those positions really are. Does that make (logical) sense to you?


 * So my actual question is (3) what are (/do you know about) other peoples views, and (4) what compromises do you think they are willing/able to make?


 * So far, from diverse answers, I've already learned that there are at least 2 different definitions of secondary sources, and (elsewhere) I've learned that sociologists treat sources in one way and biomedical researchers treat them in another way.


 * I wonder what kind of things you might be able to pick up yourself?


 * Finally, (2) are you really that absolutely certain of yourself that you could never be wrong, and no compromise is ever possible? It could be true in this case, of course, but think and see if there may yet be some way you could show some amount of flexibility to someone? Just to be sure!


 * --Kim Bruning (talk) 20:38, 3 October 2008 (UTC) The four questions are basically an intelligence-gathering exercise wrt consensus. (1) Know your own position and (3) those of the other community members, and (2 and 4) find out where compromises are possible between those two positions. Potential uncontroversial edits and potential pitfalls become obvious very quickly, that way. It also quickly becomes obvious if someone is acting in good faith or not. 


 * I really want to engage in this conversation, but I just don't get what you want me to do. I keep thinking I'm answering the questions at the top of this thread.  As for compromise?  How can there be one if two editors, without a real understanding of consensus, have caused this massive discussion.  And from what I've read, several regular editors agree.  So, please bullet point what you want me to say, and I'll respond.   Orange Marlin  Talk• Contributions 03:21, 5 October 2008 (UTC)
 * I think the massive discussion happened because no-one bothered to take the time to properly educate said 2 editors early on, at the first signs of trouble. A stitch in time saves nine. Why do I always manage to get called in so late, I wonder? ^^;;
 * Actually, there's at least 4 editors we may want to consider. You've mentioned 3 of them yourself, right?


 * Taking things step by step in wiki-time will be slow going, but let's try. This also means I need to expand questions quite a bit, to come to the following long-form. (and I'm not even being exhaustive yet, I'm sure ^^;;)
 * (2) Identify a number of flaws with the current state of the page, where's room for improvement?
 * (2) Rules by necessity sometimes have an arbitrary element (eg. some countries say you must drive on the left, some say drive on the right, it's arbitrary, but as long as everyone does the same thing, there won't be any accidents). Identify arbitrary elements in the page.
 * (2) Divide aspects of the page into those that are essential to you and those that are less essential. Which aspects of the page could be deleted or altered, without essentially harming (your intent for) the page? You may have already partially answered this question with the 2 points above. If there is a lot to consider, list aspects in order of priority.
 * (2) Summarize some low priority aspects that could be altered, in as few words as possible (to prevent TLDR ;-) )
 * The answer to question 2 tells you how much room you have to maneuver. You may be able to sacrifice something with a low priority to gain consensus on something with a higher priority.
 * (3) Name all the participants who have edited the page. Separately, name those who participate on the talk page.
 * (3) Examine the opinion of each participant. What would this person write if they were editing the page by themselves? summarize it. (Do not discard the opinion of any participant!)
 * (3) Note which participants tend to work together and/or agree with each other
 * (3) Using the data from the above two points, cluster the participants into groups. (the less groups, the better you can summarize, but beware of overgeneralization! IMPORTANT: This particular clustering is a means to summarize data and reduce work -for your convenience only-, it is not indicative of actual cliques or cabals.)
 * (3) for each group, determine their primary course of action. How would they write the page if no other group was present? Summarize
 * The answer to question 3 is -by necessity- imperfect, as you are basing yourself on external information. It is best considered a hypothesis. Later steps will test this hypothesis (the most obvious approach being to simply ask people if your hypothesis is correct or not :-), though other approaches exist as well )
 * (4) The answer to question 3 provides you with a number of groups and their objectives. Like yourself, these groups are attempting to reach consensus, and are maneuvering for position. Like yourself they'll be trying to find answers to question 2. For each group: what will the members of that group answer for question 2?
 * If you have trouble finding a single answer for each group, perhaps you need to revisit question 3
 * The answer to question 4 is -by necessity- even less perfect than the answer to question 3. Not only must you base yourself on external information, but you may also need to speculate more about other people's motives. As discussion progresses, you may find yourself updating the answers to question 4 often.


 * Perhaps it's a good idea to answer just a few points at a time, so we can go over each step? Let's take our time :-) --Kim Bruning (talk) 04:57, 5 October 2008 (UTC)


 * I wonder if there's a better way in this case? --Kim Bruning (talk) 05:35, 5 October 2008 (UTC)

LeeVanJackson comments

 * 1) As an jackson of all trades I was trying to make sense of numerous seemingly out-of-place facts on a medical article and spent hours(years even) trawling around primary papers, I was referred here as part of a GA review, suddenly the penny clicked, some of the references were out of place, some put there in good faith - others promoting so and so research or institutes, readdressing using reviews to double check and leaving primary papers for specific facts and whola article starts making sense :) My position is as long as editors reading this guide ( note no _line / essay / policy - since it's exact status doesn't matter as long as it's helpful ;) can be saved the same time and confusion, it's ok by me!
 * 2) I have not contributed to the actual guide, but anything that moves confrontation to collaboration ( in keeping with 1.) and let's these good editors get on with their admirable passtime(s:).
 * 3) I think misunderstandings of the complicated business of consensus has caused some editor's to dig their heels in.
 * 4) .. but as long as everyone feels their views have been heard respectively and fairly should be ok.
 * 5) I  think you may have stumbled on a cross-disciplinary problem, with different emphasis, respect and commercial bias of sources. Kim's pointer to a strange map of the sciences  also seems to back this fact up. This would explain vehement sticking to principles - since one discipline might not see eye-to-eye and the difficulty finding happiness. I would suggest that we may need an ancillary essay exploring the differences between disciplines, that way editors from different arenas of science could directly address the relevant sections and we'd have a collaborative - who know's might help solve some of the world's problems at the same time :) LeeVJ (talk) 22:19, 2 October 2008 (UTC)

You're seeing the same things I am! \o/

If you see a (partial) solution, try and see if you can answer the 4 questions wrt that solution? If you're careful and smart, you might be able to boil down your answer to just a few sentences per question. If you can, you're almost certain to gain consensus on that. :-)

--Kim Bruning (talk) 16:36, 3 October 2008 (UTC)

Fvasconcellos comments (not answers)
It seems everyone has left their two cents already, so I guess I should follow suit :) I disagree with the consideration that "Since primary literature in medicine is actually secondary sources, it is generally reliable". In Wikipedia, the wording "primary/ secondary/ tertiary source" always refers to primary/ secondary/ tertiary literature, making this a moot point (and I mean "moot point" in the U.S. sense of the word—please, no misunderstandings :). I also disagree (not with Paul specifically, of course) that this page is not useful for experienced editors. Have a look at Reliable sources/Noticeboard—you'll find that experienced editors and even administrators (who should, in a perfect incarnation of Wikipedia, know policies and guidelines backwards while blindfolded and sedated) need help with referencing practices. I think the intelligence-gathering exercise proposed by Kim is quite helpful, but we also need to think about how we're going to move forward once people have presented their views, so we can actually build consensus—whether for the first or the umpteenth time—and decide on the status of this page. Let's make a dance and call it "the Compromise". Fvasconcellos (t·c) 12:19, 4 October 2008 (UTC)
 * I have no major problem with the current state of this page. It could do with a little copy editing, and maybe some rewording (leaving content mostly unchanged) here and there, but that's it. It does reflect current practice (more on that later), it does not conflict in any perceivable way with WP:V, WP:NOR, or WP:RS, and it is not the same page that was rejected last year. It has grown and improved substantially—compare and.
 * I agree with Sandy and LeeVJ that the status of this page is actually of little consequence. Sure, being a guideline would (a) lend it greater credence and (2) make it known to a wider audience, but it would be no less useful (or less reliable) as a subpage of WP:MED or whatnot. WP:CHEMSTYLE (though fundamentally different in purpose) has always been in WikiProject space and that's not a problem.
 * I respectfully disagree with Paul that this page is a "Frankenstein monster", is somehow owned by Colin, and has an "anti-research paper bias". The current wording is actually abundantly clear in that respect: Reliable primary sources can add greatly to a medical article, but must be used with care because of the potential for misuse. That's it. This page in no way forbids the use of research papers or limits their use beyond "gold-standard" current practice. Paul's experiment of counting citations to primary and secondary literature in FAs is very interesting, and I'd like to see it taken one step further: note which statements are being supported by which type of literature. I believe you'll find most (if not all) recent FAs, and even one recently saved from FAR such as Chagas disease, do not conflict with the current wording of this page.
 * I haven't followed the whole discussion here, but I fully agree with Fvasconcellos' opinion stated here. --WS (talk) 12:54, 4 October 2008 (UTC)


 * The intelligence gathering is a first step - it's what I always do before I hit 'edit' or 'submit'. The next steps depend on the answers provided. There are many pages that describe what steps to use for different situations. We'll be getting to those steps soon, I think :-) --Kim Bruning (talk) 05:07, 5 October 2008 (UTC)


 * In the mean time, feel free to answer the 4 questions for yourself, if you'd like to participate in consensus formation! Of course your own opinion is important, but by itself it is not actually sufficient for us to establish a consensus with you. (normally this fact is hidden and implicit, I'm just making it explicit today, for the sake of informal mediation ) --Kim Bruning (talk) 05:14, 5 October 2008 (UTC)

Section header cleanup
The table of contents is a bit scraggly. I propose shortening some section headers and removing some others (for very-short sections), as follows: Eubulides (talk) 16:24, 1 October 2008 (UTC)
 * 'Do not use primary sources to "debunk" the conclusions of secondary sources' → 'Respect secondary sources'
 * 'Cite peer-reviewed scientific publications and check community consensus' → 'Summarize scientific consensus'
 * 'Assess the quality of evidence available' → 'Assess evidence quality'
 * 'Medical textbooks'. Remove this section header (keeping the contents).
 * 'Popular science and medicine books'. Remove this section header. Replace the following 'These' with 'Popular science and medicine books'.
 * 'Online'. Rename to 'External links', and move to the end of the page.
 * This is the TOC for the archive page? (I don't see a problem on *this* page?) --Kim Bruning (talk) 16:31, 1 October 2008 (UTC)
 * Sorry, I meant the table of contents for WP:MEDRS, the project page. Eubulides (talk) 16:36, 1 October 2008 (UTC)
 * Eubulides, I'm not sure I agree with the change to "Online". These aren't proposed "External links" for medical articles. The first set are proposed online reliable sources. We can, of course, discuss whether the set is a good one. I'm not sure we need to keep the "Background reading" section at all as they aren't proposed sources. Colin°Talk 17:16, 1 October 2008 (UTC)
 * OK, thanks, I struck the 'Online' suggestion. The other ideas are reasonable but let's make them part of a later proposal. Eubulides (talk) 17:46, 1 October 2008 (UTC)
 * Agree with the shorter titles; as I recall, we inherited them from WP:RS during the ATT debacle, and they are clunky. Sandy Georgia  (Talk) 07:48, 2 October 2008 (UTC)


 * That's probably not a problem. :-) Give me a bit of time to get the page unprotected? --Kim Bruning (talk) 16:46, 1 October 2008 (UTC) This would require ensuring there won't be an edit war. Might take 24-48 hours at a guesstimate
 * Unprotection would be a seriously bad idea. Just ask an admin to make any consensual changes for now. Colin°Talk 17:16, 1 October 2008 (UTC)
 * That's a very tempting course of action, yes. It would make it seem like I'd personally (with a little admin help) "solved" the situation quickly and easily, and I can go about showing off as Kim The Great Mediator, or some such, I suppose. :-P


 * Unfortunately, the approach of "let an admin do it" fails to encourage mutual trust, doesn't restore an equitable situation, fails to teach people how to find consensus by themselves, leaves people too dependent on administrators and/or mediators, and forces an administrator into a role they were never chosen for. All these are things we really Do Not Want.
 * So let's resist the "let an admin do it" siren song as much as possible. Does that make sense? :)


 * The next step here is to get multiple people to agree to a way of working that hypothetically precludes edit-warring, and then we take things step by step from there.


 * We can then test our hypothesis by unprotecting. If people immediately grasp a new way of thinking, sing Kumbayah, and work in perfect harmony (unusual - but possible :-P), then great! If there's hiccups, we smooth them over. But even if people immediately revert or even edit war, that provides useful information, and we can work from there. Depending on what happens, we can draw conclusions, invite people to participate in discussion, block people, or do something else entirely.


 * If something strange does happen, I'm known to be very creative. But so far, things have mostly happened the same way they always do, and there haven't been any surprises. Alright? --Kim Bruning (talk) 19:19, 1 October 2008 (UTC)


 * I see what you are trying to do. I'm just not convinced we're ready to take the stabilisers off yet. Go on. Test your hypothesis. Colin°Talk 20:19, 1 October 2008 (UTC)
 * :-) *nod*. Before we do that, we're still waiting for some feedback from Paul Gene, and it might be wise to contact Ludwigs2 too? *goes off to check* --Kim Bruning (talk) 20:34, 1 October 2008 (UTC)
 * Mostly Paul Gene at this point, I guess, though I see Matisse has a slightly different position from Colin and Eublides? I'll also wait to see if SandyGeorgia has anything to add. :-) --Kim Bruning (talk) 20:40, 1 October 2008 (UTC)
 * Well, I had great intentions many hours ago that I would make it here today, but FAC, FAR and the moon had other plans for my day. Tomorrow should be better. Sandy Georgia  (Talk) 07:48, 2 October 2008 (UTC)
 * So once again, instead of relying upon the vast opinions of numerous reliable editors, Kim Bruning decides to get the opinions of two disruptive editors. Great.  Orange Marlin  Talk• Contributions 19:29, 2 October 2008 (UTC)
 * Shorter titles are good. Is that what we're talking about here, content-wise? MastCell Talk 19:34, 2 October 2008 (UTC)
 * Yup. :-) --Kim Bruning (talk) 22:50, 2 October 2008 (UTC)
 * Orangemarlin: First off, please don't call less experienced people "disruptive editors". It's labeling, and not a very productive approach to conflicts.
 * But that said; *duh* I'm going to spend most of my time on the less experienced people. If I ask a more experienced person (like Jimbo Wales) to be civil and follow consensus, I'm not going to get much of a return on investment on that, because the experienced person will know to do that on their own. On the other hand, if I explain things to a less experienced participant in a discussion, the gain is much higher, since it adds a noticeable amount of clue to the discussion.
 * In short, I'm relying on the regulars to play nice, not make trouble, and cover my back while I work on talking with people who are not-so-regular. I'm not going to get any trouble from any particular regular person, am I? :-) --Kim Bruning (talk) 22:50, 2 October 2008 (UTC)
 * Well, I disagree. And my comment wasn't because they were inexperienced, but because they had an odd definition of consensus, which is disruptive.  Ludwigs2 has been blocked for edit warring about 4 or 5 times.  Not sure why we require his opinion on anything useful.   Orange Marlin  Talk• Contributions 00:44, 3 October 2008 (UTC)
 * Well, let's find out, shall we? You may be surprised! --Kim Bruning (talk) 16:39, 3 October 2008 (UTC)
 * Kim, people don't change. Ludwigs has been blocked 5 times. He will be blocked 5 more.  I don't AGF disruptive editors.   Orange Marlin  Talk• Contributions 17:41, 3 October 2008 (UTC)
 * Some people learn. Some don't. Those that don't are rightly banned. Those that do often become our better contributors. --Kim Bruning (talk) 18:15, 3 October 2008 (UTC)
 * I'm much more realistic and cynical. We balance out each other.   Orange Marlin  Talk• Contributions 19:57, 3 October 2008 (UTC)

As these changes are unrelated to the dispute and there seems to be clear consensus, I went ahead and made the changes. --WS (talk) 11:49, 4 October 2008 (UTC)
 * Dang! I'd been saving those for when we unprotect the page as a set of easy edits to establish trust. O:-) No matter, I'm sure We'll find something else. In the mean time, thank you very much for taking the initiative, that's worth quite a lot by itself. Will you be around in the coming days? :-) --Kim Bruning (talk) 02:43, 5 October 2008 (UTC)

RfC Archive
An active RfC was evidently archived to /Archive 2. I'm not sure if there was discussion about this, but I would recommend either unarchiving it, or turning it off (removing the template). These things generally run 30 days and then automatically turn themselves off, but in less time than that, premature archiving ends up with the odd situation of a "live" RfC in the archive, and a link from the RfC page that sends interested editors to an archive page (not a good idea): Template:RFCpolicy list. If no one else has a preference, I'll go ahead and unarchive it, but I wanted to check first. --Elonka 22:27, 1 October 2008 (UTC)
 * No additional comments in the last 10 days. Colin°Talk 22:43, 1 October 2008 (UTC)
 * The discussion and consensus about archiving the RfC is in the same linked page as the archived RfC. (I looked in the archive and can't decipher what is needed to "turn it off".)  Sandy Georgia  (Talk) 22:49, 1 October 2008 (UTC)
 * Okay, I got it (I nowiki-ed the template). The bot should notice within the next hour or so, and automatically update the RfC list. I'll keep an eye on it and tweak as needed if that wasn't enough. --Elonka 23:24, 1 October 2008 (UTC)

An example of the problem
As an example of one of the areas where this guideline is essential, I invite your attention to our article on colloidal silver. This product is marketed as the cure to whatever-ails-ya. There are no data indicating its effectiveness, and it has the unfortunate tendency to turn people blue, usually permanently, if they use too much. Numerous secondary sources note the ineffectiveness and potential toxicity of this product: This is supported by numerous primary sources (articles in the peer-reviewed medical literature) attesting to complications of colloidal silver use. Now view this edit. It cites a handful of long-outdated, unrelated, or cherry-picked primary sources to counter the clear and unanimous opinion of medical experts as expressed by the secondary sources above. MastCell Talk 22:48, 5 October 2008 (UTC)
 * Review from the M. D. Anderson Cancer Center.
 * Review from the Memorial Sloan-Kettering Cancer Center.
 * The U.S. Food and Drug Administration: (see also here)
 * The Australian Therapeutic Goods Administration: see here

My problem regarding this discussion
My problem is that much of my graduate education in my field consisted of indoctrination in the use of the "scientific method" and the associated rules and methodologies for evaluating data. This has served me well in my professional life. (I won't wikilink to the Wikipedia article on the scientific method because I have no faith in the accuracy of the Wikipedia article on the subject.) Because of the ethics in my field, I cannot compromise on this subject personally. This is why, long ago, I learned to avoid editing, or being involved in any way, in articles in my field. I am willing to avoid editing articles that do not respect the scientific method. I believe, however, that the lack of respect for the scientific method is responsible for the deplorable state of the articles in my field. There is one FA on a fairly limited subject in my field that is very large in number of Wikipedia articles.

Bottom line: I have very little room to compromise. Consensus on Wikipedia and scientific consensus in the real world are unrelated. &mdash; Mattisse (Talk) 00:04, 6 October 2008 (UTC)
 * Mattisse, I understand that this topic may be too close to your heart for you to feel able to endorse a compromise you are uncomfortable with, and therefore feel you can't participate in consensual editing if this leads away from your principles [am I interpreting this correctly?]. However, I encourage you to stick around here as there is certainly room for editors to impart wisdom from their (real world) experiences, without fully joining in the editing process. Colin°Talk 08:51, 6 October 2008 (UTC)


 * My further problem is that I can no longer follow this discussion. If it is taking place I do not know where.


 * Is there still a discussion of primary versus secondary sources? Somewhere, I thought I saw that Eubulides made a comment that PMID articles are frequently out of date. I have found PMID articles to be frequently used in misleading ways in articles by general editors. The claim is that because the article is a scientific study,  it counts more. Never, in my experience, is such an article evaluated for methodology or relevance timewise in the wikipedia article. Often editors take a general statement or two from the Abstract and use that  to support statements in the article.  &mdash; Mattisse  (Talk) 18:53, 9 October 2008 (UTC)
 * The discussion seems mostly resolved. User:Paul gene's complaints were based on misunderstanding the text, which means exactly what it says, not something sorta like what it says.  He now hopes to change the text to make it less likely to be misunderstood, and perhaps also to make it more supportive of his personal preferences in the process.  The silence after his recent proposal indicates both non-acceptance of his specific proposal and weariness with the general process.  I think we all have more useful things to do at this point.  WhatamIdoing (talk) 19:23, 9 October 2008 (UTC)


 * Great! Thanks for the info. &mdash; Mattisse  (Talk) 19:40, 9 October 2008 (UTC)
 * WhatAmIDoing is slightly optimistic, perhaps, though he does summarize the discussed positions. I think we have Paul's issue boiled down to tasks that can be resolved through editing now. This does not necessarily mean that other issues might not crop up, in steps that follow. We'll find out the truth when we unprotect the page, eh? O:-) --Kim Bruning (talk) 23:15, 9 October 2008 (UTC)

Taking a back seat
I'm going to take a back seat for a while. I've been involved in most discussions at MEDMOS and MEDRS since their creation. This last month has been exhausing and I need a break from it. With MEDRS especially, I always hoped that more experienced editors (both on Wiki and in real life) would come on board and push it forward. Well, there's loads of experienced editors on this talk page and I want to read you guys for a while rather than staring at my own words in the preview window.

For those who haven't spotted, this edit by WhatamIdoing seemed to be the turning point, leading to this reply by Paul. Note that WhatamIdoing repeated the guideline's exact words, followed by a clarification on what it does not say. Please read the discussion that followed in Paul's section. Currently, I see no pressing need to alter the following two sentences:


 * In general, Wikipedia's medical articles should be based upon published, reliable secondary sources whenever possible. Reliable primary sources can add greatly to a medical article, but must be used with care because of the potential for misuse.

since "in general"; "based upon"; "can" and "be used" all indicate we do not mean "should always cite secondary" as Paul suggests "some people" may take it.

Kim has asked Paul and I to play at consensual editing here but I don't have the heart for it right now, to be honest. No offence to Paul -- another topic and another time, perhaps. I don't believe consensus is to be found in a straight line halfway between me and Paul. Consensus is a team game in three dimensions. Over to you [plural]. Colin°Talk 12:30, 6 October 2008 (UTC)

Let's remove tag on Popular press
The above discussion has been going on for two weeks now, and with complete unanimity on the topic of the popular press. So, let's remove the disputedtag on WP:MEDRS. Eubulides (talk) 23:34, 9 October 2008 (UTC)


 * Support. JFW | T@lk  00:13, 10 October 2008 (UTC)
 * Support Orange Marlin  Talk• Contributions 00:38, 10 October 2008 (UTC)
 * Oppose, just because someone isn't typing on this page 24 hours per day doesn't mean there's unanimity. --Mihai cartoaje (talk) 08:34, 10 October 2008 (UTC)
 * Actually, the lack of discussion on this topic is a reason to remove the disputed tag. The guideline says "This template is only for ongoing, active disputes that are evidenced in talk page discussion. It is not intended for flagging a projectpage or section as vaguely controversial, nor for indicating a personal dislike of the document. There is no such thing as an indefinitely disputed policy or guideline." There was a discussion on this, and the overwhelming response agreed with the guideline. Colin°Talk 10:50, 10 October 2008 (UTC)
 * See the essay Silence and consensus, ya need to squeak. WLU (t) (c) (rules -  simple rules) 13:29, 10 October 2008 (UTC)
 * (S)he squeaked, which is grounds for listening! ;-)
 * Go ahead Mihai cartoje? --Kim Bruning (talk) 09:20, 15 October 2008 (UTC)
 * Support, no basis for it. Sandy Georgia  (Talk) 08:50, 10 October 2008 (UTC)
 * Support, of course. Colin°Talk 10:50, 10 October 2008 (UTC)
 * Support - never did agree with tag. &mdash; Mattisse (Talk) 13:11, 10 October 2008 (UTC)
 * Support, though I note that the discussion of the laysummary = parameter in cite journal is an opening for errors within the popular press to creep in. Might be worth a re-stating that the the main page is to be based on the citation and not the lay summary but that might also be redundant.  I'm a huge fan of instruction creep  WLU (t) (c) (rules -  simple rules) 13:29, 10 October 2008 (UTC)
 * Support the removal of the tag as stale. Verbal   chat  13:49, 10 October 2008 (UTC)
 * Support. WLU, removing the tag doesn't mean the text cant't be tweaked—it will, of course, still be open to discussion. Fvasconcellos (t·c) 13:57, 10 October 2008 (UTC)
 * Ja, agree. I don't even think it's sufficiently problematic to advocate a change, it's more my gut reaction to re-reading the paragraph.  It's very much implicit anyway.  Incidentally, it may also lead to fights between editors on the "best" lay-summary if reported in several mediums (media?).  But there's always WP:UCS as a rebuttal.  WLU (t) (c) (rules -  simple rules) 14:05, 10 October 2008 (UTC)
 * Sure: If not unanimity (which is basically unheard-of on Wikipedia), there is at least consensus to move forward. The section isn't set in stone, but it can at least be de-tagged. MastCell Talk 18:44, 10 October 2008 (UTC)
 * Support. It seems stale and unnecessary at this point.  <b style="color:#629632;">Celarnor</b> <sup style="color:#7733ff;">Talk to me  19:02, 10 October 2008 (UTC)

No change to any page should ever be made on the basis of a poll alone. Also, I don't want admins editing the page at all if possible, I'd prefer if you fine folks edited it yourselves, of course! :-)

Now, here there's one dissenting opinion, which is the one thing of value here. I'd like to hear about the dissenting opinion, please. (It ain't just a good idea, it's the rule). Mihai cartoaje, can you explain why you're opposing please?--Kim Bruning (talk) 09:27, 15 October 2008 (UTC) ''Is everyone familiar with requests for adminship, and how people often end up in discussions with the dissenters, but hardly ever with the supporters? Same mechanism here! :-)''
 * The popular press is allowed everywhere else. Having different rules for different topics would mean less scrutiny, so it would be abused by tendentious editors. In psychiatry, there is disagreement between forced-drugging advocates and people who support human rights. The essay is biased by saying that only forced-drugging advocates are sources and that people who support human rights are not sources. It is contrary to our neutrality and fair representation policies. --Mihai cartoaje (talk) 15:24, 16 October 2008 (UTC)
 * Mihai, do you see anything in MEDRS that actually disallows the appropriate use of popular press articles? I don't.
 * This guideline say that the popular press is "generally not a reliable source for science and medicine information" and that "A news article should not be used as a sole source for a medical fact or figure". I highlight these words because they are important.  Actual, concrete, scientific facts, like the number of people that get horrible side effects from a drug, are best sourced to a high-quality scientific source, and not to an industry (or anti-industry) rag.
 * This guideline then goes on to say that the popular press is a good source for social issues. Can we agree that government actions, such as court-ordered treatment, constitute social issues instead of scientific facts?  WhatamIdoing (talk) 18:48, 16 October 2008 (UTC)
 * I stopped arguing with you when you started using personal attacks. --Mihai cartoaje (talk) 03:46, 17 October 2008 (UTC)
 * I am thoroughly confused by this response. I have said nothing about you as a person.  I quoted what the guideline says, I identified the specific words that I thought were relevant to this discussion, and I asked a question.  There is not a single word in my response that could possibly be construed as saying anything about you, much less saying anything negative about you.  WhatamIdoing (talk) 05:31, 17 October 2008 (UTC)
 * @Mihai cartoaje: is there a specific case or article you're thinking of? --Kim Bruning (talk) 22:40, 17 October 2008 (UTC)
 * To answer the questions:
 * 1. Having different rules for different topics would mean less scrutiny, so it would be abused by tendentious editors.
 * 2. Having different rules for different topics would mean less scrutiny, so it would be abused by tendentious editors.
 * 3. WhatamIdoing, Jfdwolff, MastCell, Cyclonenim, Casliber, Mattisse and OrangeMarlin are pov pushers who have already tried to remove all criticism from the Biological psychiatry article, remove all information about malpractice from the Medicine article, etc... If you look at the discussions about removing all the information about malpractice from the Medicine article you will see a lot of overlap in the names: . SandyGeorgia's topic area is Tourette syndrome and Colin's topic area is epilepsy. Neither of them have experience on controversial topics and have voted based on their topic areas without considering controversial topics. The others I haven't interacted with and it's difficult to have an impression from only a comment. For example: Arcadian only voted support.
 * 4. About the pov pushers listed above: they try to silence everyone who supports human rights. For example, MastCell tried to delete the MindFreedom International article: . All my assumptions of good faith of them turned out to be false. --Mihai cartoaje (talk) 08:52, 27 October 2008 (UTC)


 * Your concern seems to be that MEDRS might affect the sourcing requirements on a discussion of malpractice. I don't see that MEDRS has anything to say on that issue. While malpractice is likely to be discussed and analysed in medical journals, it is also a social and legal issue that is dealt with by the press and other non-medical sources. If one of the above editors is citing MEDRS when removing such text, then they might be wrong (a diff would help). FWIW, I don't think MEDRS introduces "different rules". I hope that, as a guideline, is is merely helping editors apply other rules and policy wrt medical facts and articles. There is a consensus that the popular press generally fails WP:V's requirement for sources with a "reputation for fact-checking and accuracy" wrt medical facts. But, for example, a legal case of malpractice against a doctor is likely to be reported by the press with some degree of care. Colin°Talk 11:52, 27 October 2008 (UTC)


 * Mihai, if your position (question 1) and the position of other editors (question 2) are exactly the same, then what's the problem?
 * I'd also suggest that you go back and carefully review the accusations you're making about POV pushing. I believe you'll find, for example, that I've not edited any of the articles you name.  WhatamIdoing (talk) 18:13, 27 October 2008 (UTC)

@Mihai cartoaje: I see. That *is* a large can of worms. Let me think about it for a little while. --Kim Bruning (talk) 19:44, 27 October 2008 (UTC)


 * It's a remarkably small can of worms, in fact. Any process is open to abuse by tendentious editors. We have different "rules" for different topics because they are different, for the same reason there are different "rules" for apples and oranges. The remainder of Mihai's post is not worthy of response. MastCell Talk 20:05, 27 October 2008 (UTC)


 * Mihai, the cases you are referring to are not actually relevant to this policy. Deletion of MindFreedom International is a notability issue, not a sourcing one. My suppression of your content on medicine had to do with the fact that your edits reflected on the specific area of malpractice legislation in Canada, something that would be disproportionate for the article attempting to discuss the breadth of medical practice through the ages and worldwide.
 * Discounting Colin's and SandyGeorgia's votes because they have a particular interest is odd. You have a particular interest in mental healthcare and legal parameters to involuntary treatment. Does that disqualify you as a voice in this discussion? JFW | T@lk  20:32, 27 October 2008 (UTC)


 * I am being called a "POV pusher" by one editor who alleges that I "already tried to remove all criticism from the Biological psychiatry article, remove all information about malpractice from the Medicine article, etc...". Please find one instance where I have done this. One editor, Mihai cartoaje,  (who did not follow Kim's time consuming rules above, that  were "required" in order to participate in this discussion) is now calling me a "POV pusher" because my opinion is at odds with his and is in accord with the overwhelming majority? What is the point of all this?  &mdash; Mattisse  (Talk) 20:51, 27 October 2008 (UTC)


 * Response to Mihai cartoaje
 * 1) The popular press is allowed everywhere else.
 * It's not disallowed here. This page is in line with WP:V:  In general, the most reliable sources are peer-reviewed journals and books published in university presses; university-level textbooks; magazines, journals, and books published by respected publishing houses; and mainstream newspapers. As a rule of thumb, the greater the degree of scrutiny involved in checking facts, analyzing legal issues, and scrutinizing the evidence and arguments of a particular work, the more reliable it is.
 * 1) Having different rules for different topics would mean less scrutiny, so it would be abused by tendentious editors.
 * Disagree. First, there are no "different rules".  Second, tendendtious editors tend to favor the popular press, as they can find something in the news to back even the most fringe of fringe theories, and even when peer-reviewed research refutes their conclusions.  Sandy Georgia  (Talk) 17:51, 28 October 2008 (UTC)
 * 1) SandyGeorgia's topic area is Tourette syndrome and Colin's topic area is epilepsy.  Neither of them have experience on controversial topics and have voted based on their topic areas without considering controversial topics.
 * Not so at all. First, Tourette syndrome is not at all uncontroversial, and I first got a Wiki account initially to engage in a mediation. It may appear to be uncontroversial now because it is well cited and well written, so hasn't come under attack recently by fringe elements (darn, WP:BEANS).  And you neglect to mention Colin's and my participation in several different articles that are and were controversial:  autism, Asperger syndrome, schizophrenia, Alzheimer's disease, Lyme disease and many others (too many to list).  I "voted" based on having seen the kinds of sources tendentious editors use to introduce fringe theories to medical articles, even when peer-reviewed secondary souce journal articles disagree.  Sandy Georgia  (Talk) 17:51, 28 October 2008 (UTC)

Kim,


 * 1) The tag was removed because there was "no active discussion", which is part of the guidelines for maintaining such a tag ("If there is no active discussion, then the tag may be removed by any editor."). The poll is regrettable (see below) but irrelevant as far as Steven's admin action was concerned.
 * 2) On the basis of what is written above, we only have a "dissenting opinion" on whether the disputed tag should remain. Mihai wishes the tag worked in ways that it doesn't and if he wants to change that he can discuss it over at Template talk:Disputedtag. We haven't been given (despite a request to "squeak") a dissenting opinion on the section itself. Rather than being "of value", such comments merely wastes people's time and leads to folk debating a bloody tag rather than the wording of the article. We wasted a month debating a guideline tag rather than productively discussing the content of the article.

It would be more helpful, if rather than lecturing us on how WP works, you agreed that the disputed tag currently has no justification, was removed correctly, and that if Mihai wishes to discuss the content of that section, he need only press the little [+] button at the top of this page. Should such discussion indicate a dispute, then the tag may once again be justified. Colin°Talk 11:27, 15 October 2008 (UTC)


 * I agree that Mihai hasn't shown up yet, so we can proceed with the current state for now. Just remember that we may need to backtrack later. We need to be able to show that we were scrupulously fair to everyone, else changes we make will eventually not be accepted by the larger community. We need to keep in mind what will happen when the page is unprotected, as it will be very easy to enter the bold-revert-discuss cycle, or even go back to edit warring. Obviously this is not my preference. --Kim Bruning (talk) 18:08, 15 October 2008 (UTC) Those who forget history are doomed to repeat it. ;-)

On WP:SILENCE, and unprotection
WP:SILENCE presupposes that a page is not protected. So if we'd want to test if WP:SILENCE applies, we'd need to unprotect the page now, and see if there's a revert (which heads us into WP:BRD territory).

Some people seem to be apprehensive about such a move though. I am kind of curious what would happen if the page were to be unprotected now. Would anyone care to make predictions? Would anyone still edit war? If so, who, and on what grounds? --Kim Bruning (talk) 10:03, 15 October 2008 (UTC) <Small>this falls under question 3, in fact :-)


 * Silence is not always broken by a revert, and protection does not completely prevent editors voicing their disagreement. Saying "let's see if there's a revert" seems to be goading editors into the worst possible behaviour. How about "let's see if folk can make productive edits"? I think this page should be unprotected, if only because we've sunk into consensus paralysis where editors can't do simple things (such as removing stale disputed tags) without determining consensus (albeit in a flawed way) beforehand. Colin°Talk 11:27, 15 October 2008 (UTC)


 * Let's unprotect. --Steven Fruitsmaak (Reply) 11:40, 15 October 2008 (UTC)


 * Agree to unprotect. I would be surprised at a reversion, given there had been plenty of discussion and encouragement of even more (although the structure and mandatory discussion format has been confusing with apparently nothing accomplished in terms of moving forward). Hence, a straw vote took place over one issue in frustration over the enforced editorial paralysis. As per WP:SILENCE, if one person out of 11 squeaks without any explanation  in a straw vote, and has made no further comment either before or after, and that falls under WP:SILENCE and is seen to promote and justify a reversion, then in my view  WP:SILENCE is deeply flawed. I see overwhelming consensus here; a reversion without discussion first would not be bold but completely inappropriate. &mdash; Mattisse  (Talk) 14:22, 15 October 2008 (UTC)


 * Further, I propose we drop the current confusing discussion format and adopt one that more straightforwardly addresses specific issues. These can be tackled in smaller chunks at a time, I think, without swallowing the whole bolus at once. We seem to be bogged down with no progress, except for the few consensus changes made by editors discussed above. &mdash; Mattisse  (Talk) 14:41, 15 October 2008 (UTC)


 * Nice try. :-) But if you can't answer the 4 questions, you don't get to edit. Alright?
 * I'll gladly walk you through the 4 steps in any manner you like, using any medium you like, and I can/shall protect you from any abuse that might arise, provided you do so. In fact, if that wasn't explicit before, I'm making it explicit now. Fair? --Kim Bruning (talk) 17:48, 15 October 2008 (UTC)
 * Kim, I don't suppose you're familiar with WP:PPP? You're investing (or wasting, depending on the POV) an enormous amount of energy in process, and it's the final product that really matters.  We have work to do -- work on regular articles -- and the elaborate process on this page has been impeding that work by consuming everyone's time and attention.  Rather than imposing another process rule, how about following a practical content-driven rule?  As in, don't bother proposing any changes here until you've got a real, live conflict in a regular article where common sense and good editing is being prevented by (misunderstandings of) this guideline.  WhatamIdoing (talk) 19:23, 15 October 2008 (UTC)


 * I was not asking "to get to edit". I was proposing that we drop the confusing discussion format on this page, unreadable now, and more clearly address specific issues. I have never edited the article page, but it is good to know that you have decided that I "don't get to edit". Frankly, it makes my head ache to try to decipher this talk page and the interminable discussions on it.


 * I guess you are saying, that I have no voice on this page (WP:SILENCE) because I cannot fathom your way of doing things. SandyGeorgia said nothing that I did not say, so is she allowed to voice opinions here? She said, "I broadly agree with the answers from Colin, Eubulides, Jfdwolff and Mattisse...", then said in different words approximately what I said. Well, I broadly agree with her. Your answer to her was, "Thank you. You sort of answer the 4 "question essential to consensus" that I posed, but the answers are intermingled. If at some point you find time to organize your thoughts further, that would be appreciated. :-)".


 * If I intermingled my answers as she did, would that qualify? I looked at the massive number of questions you are requiring Orangemarlin to answer. I don't have several days to pore over this talk page discussion  plus the versions of the article (to determine who edited the page, what their opinions are,  who tends to work together, how their editing behavior clustered, and speculate how each would write the article), organize all this information (not over generalizing) and write it all down&mdash;the massive amount of work required give you answers. This feels like a school exam. Or is this a game show like Big Brother where I have to memorize qualities about the house guests? &mdash; Mattisse  (Talk) 20:39, 15 October 2008 (UTC)
 * Kim's questions
 * (2) Identify a number of flaws with the current state of the page, where's room for improvement?
 * (2) Rules by necessity sometimes have an arbitrary element (eg. some countries say you must drive on the left, some say drive on the right, it's arbitrary, but as long as everyone does the same thing, there won't be any accidents). Identify arbitrary elements in the page.
 * (2) Divide aspects of the page into those that are essential to you and those that are less essential. Which aspects of the page could be deleted or altered, without essentially harming (your intent for) the page? You may have already partially answered this question with the 2 points above. If there is a lot to consider, list aspects in order of priority.
 * (2) Summarize some low priority aspects that could be altered, in as few words as possible (to prevent TLDR ;-) )
 * The answer to question 2 tells you how much room you have to maneuver. You may be able to sacrifice something with a low priority to gain consensus on something with a higher priority.
 * (3) Name all the participants who have edited the page. Separately, name those who participate on the talk page.
 * (3) Examine the opinion of each participant. What would this person write if they were editing the page by themselves? summarize it. (Do not discard the opinion of any participant!)
 * (3) Note which participants tend to work together and/or agree with each other
 * (3) Using the data from the above two points, cluster the participants into groups. (the less groups, the better you can summarize, but beware of overgeneralization! IMPORTANT: This particular clustering is a means to summarize data and reduce work -for your convenience only-, it is not indicative of actual cliques or cabals.)
 * (3) for each group, determine their primary course of action. How would they write the page if no other group was present? Summarize
 * The answer to question 3 is -by necessity- imperfect, as you are basing yourself on external information. It is best considered a hypothesis. Later steps will test this hypothesis (the most obvious approach being to simply ask people if your hypothesis is correct or not :-), though other approaches exist as well )
 * (4) The answer to question 3 provides you with a number of groups and their objectives. Like yourself, these groups are attempting to reach consensus, and are maneuvering for position. Like yourself they'll be trying to find answers to question 2. For each group: what will the members of that group answer for question 2?
 * If you have trouble finding a single answer for each group, perhaps you need to revisit question 3
 * The answer to question 4 is -by necessity- even less perfect than the answer to question 3. Not only must you base yourself on external information, but you may also need to speculate more about other people's motives. As discussion progresses, you may find yourself updating the answers to question 4 often.


 * Mattisse's answers to Kim's questions above
 * (2)The page is fine and I cannot identify a number of flaws.
 * (2)I identified what I accepted and would not accept in my answers above, in the section under my name.
 * (2)Low priority aspects that could be altered are the headings. Perhaps the wording could be more elegant. Depending on the ultimate content (whether it is in accord with my beliefs as stated above in the section under my name), it is a high priority that this page be a guideline. I don't know what TLDR means.
 * (2)The article history includes SandyGeorgia, Eubulides, Colin, Mastcell, OrangeMarlin and Paul Gene, as well as a number of people who are not participating on this talk page discussion, some of them quite extensively such as Petersam. The others made only a few edits and apparently are not interested enough in the article to follow what is happening now.
 * (3)The people who participated on the talk page are Paul Gene, SandyGeorgia, Colin, Eubulides, Jfdwolff, OrangeMarlin, Fvasconcellos, MastCell, Mattisse. A number of people gave one or two comments but did not participant to any extent.
 * (3)I believe SandyGeorgia, Colin, Eubulides, Jfdwolff, OrangeMarlin, Fvasconcellos, MastCell  and I could work together. I believe Paul Gene and Mihai cartoaje perhaps could work together, although I have no idea if they have any common ground. As Sandy, Fvasconcellos and LeeVJ regard the status of this page as of little consequence, and perhaps do not care that much what it says (they believe RS and V policies cover the issue) they appear to be less interested in the issues. LeeVanJackson and EverSince appear to have little interest in the particular issues regarding medicine-related articles nor have particular beliefs.
 * (3)I would cluster Colin,  Eubulides, Jfdwolff, OrangeMarlin, Fvasconcellos  and me as supporting the current article status and content. I would cluster SandyGeorgia, Fvasconcellos and LeeVJ as not being that interested as they feel other Wikipedia policies cover the issue.   I would cluster Paul Gene separately.  I would cluster EverSince, LeeVanJackson  and Mihai cartoaje  as basically uninvolved.
 * (3)I believe Paul Gene would write the page according to his beliefs that primary sources are to be emphasized, although his beliefs on this issue are  in dispute and have not been clarified recently. It appears that he has a unique view about use of general news articles, but I am not clear what it is, i.e. whether it is more or less inclusive. I do not know how Mihai cartoaje would write the page as his beliefs appear to revolve around WP:SILENCE and not the article content.  I believe SandyGeorgia, Colin,  Eubulides, Jfdwolff, OrangeMarlin, Fvasconcellos, Mastcell  and I would keep the article close to its current state. LeeVanJackson and Eversince do  not appear to have much experience with the issues regarding the article and would be uninterested in making it a guideline or in particular issues of medicine-related content.
 * (4)I do not know enough about the others to answer this question. From what I can tell, everyone has been extraordinarily patient but they are about to wear out and withdraw from participation for a while. Paul Gene may have already done so as he has made no recent comments.
 * Hope I got the names clustered correctly and the views described correctly as it is very confusing to follow. I get some of the names mixed up. &mdash; Mattisse (Talk) 20:34, 15 October 2008 (UTC)
 * Kim has repeatedly asked User:Paul gene not to respond to other people's comments as Kim considers Paul's responses to be shooting himself in the foot. I don't think that the absence of responses actually indicates agreement.  WhatamIdoing (talk) 22:59, 15 October 2008 (UTC)

(undent) @Matisse: Cool! You don't need to read the entire page all the time if you don't want to, if you just talk with me for now, that works fine. :-)

But it looks like you read through the entire page anyway. And you answered the long version of the questions. I sincerely appreciate the effort.

The reason I'm asking everyone to answer these questions is to explicitly check whether they understand the current consensus (and/or at least make people think about it). Obviously, it's not a good idea to let people near the page if they don't understand what the current consensus is.

More directly, what the questions let met do is to check what assumptions one person is making against answers other people are giving. (So your answer to question 3 about Paul can be checked against Paul's answer 1 +any consequent statements he has made).

Most of your answers are pretty perceptive too!

Now that I know your position, and your understanding of the current consensus, I'm able to discuss with you directly.

So far, I think I've spotted one misconception. You state that Paul Gene would prefer that primary sources be emphasized. AFAICT, he now agrees with Colin on how a medical article should be written on wikipedia: First build the framework using mostly secondary sources, and (only) use primary sources to fill in parts not covered by those secondary sources. (this is my own summary, and I take full responsibility if I have any misconceptions)

Do you yourself also think that this is a fair or correct approach? If not, what flaws do you see? --Kim Bruning (talk) 01:30, 16 October 2008 (UTC)
 * Well, I don't think that is quite what Colin said. I don't think his statement was quite that rigid. But I agree with whatever he did say. Too tired to go find exactly what he did say now but I remember agreeing with it at the time I read it.  I have not seen a recent statement of Paul Gene so I do not know if he now agrees with Colin or not.  &mdash; Mattisse  (Talk) 03:03, 16 October 2008 (UTC)
 * Ok, I think that's probably good enough to say there's a consensus between the three of you then (Though it's probably a good idea to doublecheck me, to be sure I haven't missed any important details.). --Kim Bruning (talk) 15:56, 16 October 2008 (UTC) How long did that take (in posts and/or hours) from the moment you posted your answers to the questions? :-) Oh, three or four hours. &mdash; Mattisse  (Talk) 18:56, 16 October 2008 (UTC)

@WhatamIdoing: I'm quite familiar with WP:PPP, and agree with it. :-) The problem I'm encountering here is that people don't always seem to be carefully checking whether each of their edits has consensus before they make them. So I'm sort of trying to find out what's causing all the trouble.

It's a bit like taking a car apart to really check everything for a change. It looks all compact under the bonnet, but if you take out all the parts to check them, you have this huge mess of components on the floor. Obviously, at some point everything goes back under the bonnet in a well-repaired, well-oiled state, and we can make much faster progress. :-) --Kim Bruning (talk) 01:41, 16 October 2008 (UTC) I'm hoping to see consensus purring along soon after we unprotect ;-)

Ok, let's go
@Colin: Heh, you're more optimistic than I am today. I didn't want to say that, because I wasn't sure people would believe me ;-).If we get productive edits, that'd be ideal, but if there's some fits and starts, that's fine too.

@Everyone: If possible, for any edit you make, please list the 4 steps here on the talk page. Try to keep it to 1-2 sentences per step. I want to see people working towards consensus 4 steps at a time. You don't have to like each other to be able to cooperate, just follow the procedure and you'll be fine. If anything shows up, before I see it, my talk page is just a click away. :-)

If you're not sure what the reasoning should look like, please discuss with me (any time, any medium, drop me a mail for options), and I'll write one for you, the first time.

For now, just make 1 edit each, and show your reasoning in the 4 easy steps provided. If anyone does *not* follow the rule, point them here and/or to my talk page, but do not immediately revert them.

If you don't see a need to make an edit, please don't edit.

@ uninvolved admin: Please unprotect! --Kim Bruning (talk) 17:59, 15 October 2008 (UTC)


 * Didn't see the above. I was too busy figuring out how to request unprotection: here. Colin°Talk 18:11, 15 October 2008 (UTC)


 * :-) --Kim Bruning (talk) 18:13, 15 October 2008 (UTC)

Let's remove tag on Definitions
It's been ten days now with no discussion about the disputedtag tag on WP:MEDRS. Almost all the discussion has been about procedures for editing the page. There was a bit of discussion about the popular press. Let's remove that tag and then move on. It may well be time to remove protection on the project page too. Eubulides (talk) 17:51, 15 October 2008 (UTC)


 * So you feel that the definitions are currently undisputed? Then please make that your edit on unprotection. (see above) --Kim Bruning (talk) 18:10, 15 October 2008 (UTC)


 * I doubt whether all editors currently agree on this subject. However, they haven't commented here in the past 10 days. Maintenance tags like that should be removed when there is no active discussion. Eubulides (talk) 18:26, 15 October 2008 (UTC)
 * In a short while, Make the edit and find out :-). --Kim Bruning (talk) 18:29, 15 October 2008 (UTC)
 * OK, done. Eubulides (talk) 02:57, 16 October 2008 (UTC)
 * Cool! Let's see what happens. --Kim Bruning (talk) 02:58, 16 October 2008 (UTC)

Section: Online
I propose we review the Online section. Colin°Talk 19:08, 15 October 2008 (UTC)
 * 1) Compared to other sections, this offers no general advice. Can we think of any?
 * 2) The list of reliable sources contains just four entries. Should any of these be removed, qualified, or do folk have others to suggest?
 * 3) Should there be a list of unreliable online sources or types of unreliable source?
 * 4) Is the background reading section relevant for this guideline?
 * 5) Should we mention Google Scholar or other search engines. Would those be better mentioned in the Journals section?
 * 6) Google Books. Thoughts?


 * I don't use any of the online sources mentioned in WP:MEDRS, other than Pubmed. Do other editors regularly use them?
 * I've suggested before that Periodicals, Books, and Online should be combined into a single top-level section, with duplicative material removed. Almost everything's online now, for starters, so "Online" is to some extent a useless name for a section these days.
 * I suggest rewriting the combination of the three sections to be more useful to common problems of novice editors. Typically, a new editor will start with a search engine, so the combined section should emphasize search far more than WP:MEDRS does now. It might also be helpful to talk about search first, rather than last.
 * One possible way to start the ball rolling on such a rewrite would be to steal chunks from the "Search" discussion in Wikipedia Signpost/2008-06-30/Dispatches.
 * Eubulides (talk) 19:37, 15 October 2008 (UTC)

Regarding your proposals, my thoughts are the following regarding the Online section (or whatever the title will be):
 * Suggest little general advice as it tends to get dry quickly and is read only by those who already know it.
 * eMedicine has been sold to WebMD and is a consumer site. Have never used the others. Any list should links to the web sites rather than to unreliable  Wikipedia articles with "citations needed" tags. It would be great to offer a list of web links.
 * List of inappropriate online sources, especially those that tempt nonprofessional editors in Wikipedia articles, could be useful as examples.
 * Don't see point of background reading section. Either it is a reliable source or forget it.
 * Mention Google Scholar or any other search engine or search techniques under this section as the nonprofessional editor is unlikely to have access to journals or books that are not online and is more likely to use search.

Regarding your other suggestions, I think the following:
 * No, I have not used the online sources mentioned except for PubMed. They need to be checked out.
 * Have no problem combining sections, as long as accessible online links are clear, as nonprofessionals will probably start there for reasons stated above.
 * Agree with your rationale of presenting directions for search engine use first.
 * Agree that chunks from the "Search" discussion in Wikipedia Signpost/2008-06-30/Dispatches could be a good starting point, with the objective of paring the chunks down and making them more focused, less discursive, easier to scan. Including links to citation tools is a good idea


 * I really admire Scientific citation guidelines as the writing is clear and informative, all the wikilinks go to a respectable article, and it educates without preaching or using jargon. How do they get away with it? &mdash; Mattisse  (Talk) 04:22, 16 October 2008 (UTC)
 * FWIW I've found google books really helpful lately - many high-quality sources are available for free using a limited preview and extremely handy search feature. Can't say for sure how much this will apply to medical sources and pages because much of my recent work as been more social sciences than medicine, but it's definitely worth mining for sources and starting points.  WLU (t) (c) (rules -  simple rules) 17:47, 20 October 2008 (UTC)

Preferring journal sources with free-text

 * Whilst we're at it what do people think about preferring sources with free-text? When finding text on Pubmed, I perform an advanced search to find any decent articles with freely available text first, and sometimes as a backup for high-quality non-free text ones, I believe this aids verifiability for other editors ( hardly anyone has access to all journals and papers ). LeeVJ (talk) 10:33, 16 October 2008 (UTC)


 * Very good idea. &mdash; Mattisse  (Talk) 12:22, 16 October 2008 (UTC)


 * There was an attempt by Nephron and DavidRuben, way back in early 2007, to have the Citing sources guideline express a preference for open access journals. It failed, and arguably that was the wrong guideline (it deals with how to cite, not what to cite). I don't know if the attempt was repeated at WP:RS or WP:V.
 * Technically, the accessibility of sources is irrelevant to whether it is reliable. However, the general reader benefits more from a link to a free-text source than from one that will charge him $20. There are also potential benefits for the quality of the article: such sources can be accessed by lay and expert (in other fields) editors who are then able to do a more thorough review or to better collaborate, or help folk editing many months in the future. If we do say something encouraging in this regard, we should IMO give practical reasons rather than moral ones. Colin°Talk 12:33, 16 October 2008 (UTC)


 * Agree strongly. This is entirely an issue of practicality.  It encourages the nonprofessional Wikipedia editor to participate in useful and satisfying way, rather than having that editor frustrated by a series of demands for money or messages of exclusion from sites not freely accessible. Editors use sources they can access. If inappropriate ones are all they find accessible, they will use those. If we want editors to write correctly cited Wikipedia medicine-related articles, we should attempt to provide them with appropriate accessible resources for their use. Morality has nothing to do with it and should not be addressed, in my opinion. I don't understand how morality enters into the issue.  &mdash; Mattisse  (Talk) 12:50, 16 October 2008 (UTC)


 * I agree with this, and suggest that while we're stealing from Wikipedia Signpost/2008-06-30/Dispatches, we steal from its Accessing sources section, which starts off this way:
 * "Other things being equal, it is better to cite a source whose full text is freely readable, so that your readers can follow the link to the source. However, many high-impact journals, such as Nature and Science, require a fee or a subscription, and as these journals publish some of the best papers it can still be best to cite them."
 * and then goes on to give advice about free abstracts, getting copies of non-free sources, and so forth. Eubulides (talk) 16:37, 16 October 2008 (UTC)


 * That sounds good. I was also thinking that a list of sample inappropriate sites: info from the Mayo Clinic site (e.g. Clinic study suggests that proper management of asthma will decrease odds of breast cancer metastasis to the lung), WebMD: Attention Deficit Hyperactivity Disorder: What Is ADHD? (I would question this, although it is "reviewed" by a physician reviewer for Physicians' Review Network, Inc., an independent medical review organization - what do you think?), other "guidelines" sites that are popular,  and some samples of "programs for sale" that mask themselves as medical information, like Dr. So-and-So's Guide to Curing Whatever, such as Effective & Caring Stuttering Therapy Approach for Children, Teens & Adults currently a reference in Stuttering therapy. I am going to start keeping a list of the ones I see used frequently. &mdash; Mattisse  (Talk) 17:52, 16 October 2008 (UTC)
 * I agree that a brief example list of less-reliable sources would be useful. We can't of course make it exhaustive, but a list containing (say) three to five well-known sites that have reliability problems could be helpful to novice editors, to show them what sort of things to look out for. Eubulides (talk) 19:25, 16 October 2008 (UTC)
 * In principle, using accessible sources when all else is equal is good editing, but in practice, we have to be very very careful about how it is worded, so that superior sources aren't deprecated to accessibility. I'm afraid that all other things being equal may not be strong enough, and some editors may overlook the significance of that clause or remove the best sources to replace them with accessible sources, citing this page.  For example, I am personally horrified whenever I see a Mayo Clinic source, as the last time I checked, they had inaccurate info on TS.  (I haven't checked today.)  On the other hand, the most glaringly inaccurate info on TS I've ever seen was printed in the New England Journal of Medicine and is accessible, but didn't even define the condition correctly, so I would never hoist that review upon our readers ... Anyway, yes, I agree with this, but wish we could make the wording much more explicit than in the Dispatch.  Sandy Georgia  (Talk) 18:01, 16 October 2008 (UTC)
 * I agree with this comment. This comment used the phrase When all else is equal. Would it suffice to replace Other things being equal with When all else is equal in the abovementioned quote stolen from Accessing sources? If not, what other words should be added? Eubulides (talk) 19:25, 16 October 2008 (UTC)
 * I'm not a good wordsmith, but I'd like to see something even stronger if anyone can come up with it: we have to leave no doors open for editors to use this page as a reason to replace superior sources with inferior ones just because one is accessible. The very best TS reviews aren't accessible (e.g.; Advances in Neurology, more or less vetted by everyone who is anyone): I only replace them sparingly and when I'm certain the accessible review is causing no harm.  Maybe some sort of very explicit wording:  don't replace a superior source with another just because it's accessible (thinking the faulty NEJM TS review over the Advances in Neurology papers).  Sandy Georgia  (Talk) 19:31, 16 October 2008 (UTC)

It seems like there's lots of support for choosing free-text journal articles as long as it can't be used to trump an editor desire to choose the best source they have access to. Perhaps discussion of that choice should be clearly separated from reliability issues -- in its own paragraph or subsection. What is less likely to be acceptable is substituting with less scholarly freely accessible online material (such as press releases from the Mayo clinic).

I've re-titled this section and made it top-level. We can discuss non-scholarly free access online sources in the section above. Colin°Talk 20:37, 16 October 2008 (UTC)


 * It doesn't seem clear how this is an issue specific to medicine or, as mentioned, to reliability; and therefore why such decisions/guidance are the domain of this article and talk page, rather than a more central policy or guideline page. EverSince (talk) 20:53, 16 October 2008 (UTC)


 * While I think it's rather clear in the fact that many medical articles rely on journal sources, PubMed in particular, for which sometimes only abstracts are available online. Many other content areas may rely more heavily on sources that are available online (pop culture articles come to mind), which is why we may need to further explain for medical articles.  Guideline pages help explain policy for particular areas: the particularity of this area is PubMed.  Someone may be frustrated that only a PMID abstract is available, but we don't replace a superior source with Mayo clinic to avoid that.  Sandy Georgia  (Talk) 21:00, 16 October 2008 (UTC)
 * I think we all agree that the best reference shouldn't be replaced, but free text articles are helpful? How about I try some initial wording...

"Commonly the most reliable medical references are not free to access, so it is helpful to supplement these with a free text source if one is available; this must be reliable itself and cover the same subject area, without contradiction." LeeVJ (talk) 17:21, 19 October 2008 (UTC)
 * Do we actually need this? Given that many editors don't have access to non-free materials, don't you think that we have a systemic bias in favor of free materials already?  This seems WP:CREEPy to me.  WhatamIdoing (talk) 19:47, 19 October 2008 (UTC)
 * The intention would actually be to curb this bias and ensure the best refs were used primarily, and putting free-text articles into context - I'm don't think I've seen them mentioned elsewhere. It is aimed at editors who do have access to paid for sources, to point them in a direction to aid verifiability. Whether it's needed or not .. I think they should be mentioned somewhere? LeeVJ (talk) 20:14, 19 October 2008 (UTC)

(BING) Primacy should always be to the best, most reliable, highest-quality source. Accessibility should only be a concern when there are two completely equal sources (and in that situation, I'd probably cite both). Honestly, I think common sense and talk pages will be the best ways to resolve situations like this (and I think they'd be extremely unlikely anyway - how often do you find two completely equal sources, let alone one that's a free full text?).

From a purely practical standpoint, I'd suggest posting any guidance we can dredge up for two subjects mentioned here - where/how to find full text sources and what lay-sources to avoid. Emedicine and WebMD are quite tempting, and problems with them should be highlighted. Emphasizing availability rather than reliability seems very much the wrong way to go in my mind. WLU (t) (c) (rules - simple rules) 17:58, 20 October 2008 (UTC)
 * Lee, I don't think that a section titled "preferring sources with free text", or anything even remotely like that, will ever have the effect of curbing the bias towards using free materials. WhatamIdoing (talk) 19:09, 20 October 2008 (UTC)
 * WhatamIdoing, I'm didn't mean a whole new section - just as part of online sources. I concede to WLU's view, although giving instructions on finding the free text articles might help the bias further - but at least for those looking how to use them properly will have some direction.. LeeVJ (talk) 19:26, 20 October 2008 (UTC)
 * Directions on how to find free articles may increase the number of free articles available (which can only be a good thing; even having a full text to review and discard is helpful) but does not mean the free article should or will be included automatically. There's nothing inherently bad about free articles, and one really good thing (they're free!) but editors will still review each one individually to ensure they are sufficiently reliable, there is sufficient oversight and peer review, and ultimately that they are appropriate to the page.  A "how to" or starting point guide should certainly state this, but it's really the beating of a dead horse - NPOV is one of the pillars, and it is the appropriate policy to invoke because NPOV is what guides us to represent the mainsteram scholarly consensus.  Anyone trying to cite the Journal of Orthomolecular Medicine on cancer will get smacked firmly in the face with NPOV and UNDUE, and that is what will preclude it's use, not it's availability.  This might all be best covered in a MEDRS FAQ rather than the policy or main page.  Do we have a FAQ?  Might be a good idea, might be redundant, might be lengthy enough to cover aspects like "can I cite emedicine" and "where can I find good sources".  Having free sources isn't a bad thing, using them willy-nilly is, but that's just as likely to happen if free or paper.  WLU (t) (c) (rules -  simple rules) 19:52, 20 October 2008 (UTC)